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Massachusetts rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.25 / $2,747.00 / $4,806.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.25 / $188.04 / $297.79
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.87 / $819.06 / $4,755.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.85 / $313.85 / $1,419.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.49 / $186.54 / $329.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.00 / $50.00 / $50.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.13 / $330.66 / $599.73
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.30 / $214.32 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.34 / $289.80 / $518.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.97 / $324.54 / $537.09
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,376.00 / $8,498.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.21 / $580.09 / $1,419.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,640.00 / $3,372.00 / $8,425.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.74 / $312.31 / $726.58