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Massachusetts rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$726.71 / $2,663.12 / $3,625.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.41 / $684.91 / $1,129.32
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,011.74 / $2,411.51 / $8,498.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.38 / $1,318.22 / $5,117.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.98 / $927.74 / $1,656.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.82 / $1,151.40 / $1,983.41
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.51 / $1,316.46 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$825.84 / $1,007.57 / $1,401.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.89 / $1,526.75 / $2,003.01
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.00 / $3,672.00 / $16,394.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.11 / $1,481.23 / $5,117.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $3,592.00 / $8,498.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.23 / $1,114.50 / $2,288.55