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Massachusetts rates for HCPCS 40701

Plastic repair of cleft lip/nasal deformity; primary bilateral, 1-stage procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,618.00 / $3,111.85 / $8,272.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$975.67 / $1,188.03 / $1,885.40
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,939.00 / $6,280.00 / $16,547.20
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,143.65 / $1,847.98 / $8,631.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,458.01 / $1,937.26 / $4,480.72
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.09 / $1,916.82 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,309.54 / $1,629.30 / $2,249.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,475.79 / $2,796.62 / $3,922.65
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,849.84 / $7,849.84 / $7,849.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,324.00 / $7,250.00 / $26,542.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,365.68 / $1,899.50 / $8,631.98
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
$1,311.89 / $1,679.08 / $3,124.32