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Massachusetts rates for HCPCS 21175

Rcnstj Bifrontal Superior-Lat Orb Rims & Lwr Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.00 / $2,894.00 / $6,107.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,997.11 / $2,247.73 / $5,846.34
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.00 / $5,464.73 / $13,773.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,161.69 / $3,713.34 / $19,652.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,215.34 / $4,215.59 / $6,380.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,232.29 / $3,500.87 / $6,358.46
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $3,281.11 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.92 / $3,029.45 / $4,124.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,720.97 / $5,394.05 / $7,115.61
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,063.00 / $16,330.48
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,333.30 / $4,009.50 / $19,652.56
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $6,204.00 / $13,284.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,323.81 / $3,492.74 / $7,596.43