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Massachusetts rates for HCPCS 21387

Open Tx Orbital Floor Blowout Fx Combined Appr

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
$661.63 / $753.45 / $1,207.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,591.00 / $4,751.20 / $11,028.78
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$763.57 / $1,269.70 / $8,296.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.62 / $1,265.09 / $2,224.48
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$766.14 / $1,659.30 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.15 / $1,064.93 / $1,460.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$950.68 / $1,884.63 / $2,486.12
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $5,063.00 / $13,773.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$834.85 / $1,412.43 / $8,296.79
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
$813.10 / $1,196.17 / $2,367.76