go back

Massachusetts rates for HCPCS 21275

Secondary revision of orbitocraniofacial reconstruction

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,618.00 / $3,111.85 / $8,271.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.85 / $827.02 / $1,329.50
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.00 / $5,097.00 / $15,093.22
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.22 / $1,429.44 / $14,641.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$877.60 / $1,321.44 / $2,435.58
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.13 / $1,819.44 / $7,315.92
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.34 / $1,170.56 / $1,601.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,046.94 / $2,075.44 / $2,737.85
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $6,275.52 / $26,542.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$904.98 / $1,547.37 / $14,641.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $5,097.00 / $10,764.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$877.51 / $1,272.52 / $2,607.51