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Massachusetts rates for HCPCS 21245

Reconstruction of mandible or maxilla, subperiosteal implant; partial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,265.80 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,174.90 / $2,570.40
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $6,309.57 / $33,884.42
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,548.82 / $3,981.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,737.80 / $2,951.21
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $1,905.46 / $7,762.47
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,819.70 / $2,511.89
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,165.95 / $13,182.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,819.70 / $3,311.31
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $6,309.57 / $33,884.42
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,548.82 / $3,981.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $6,309.57 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,584.89 / $3,388.44