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Massachusetts rates for HCPCS 41805

Removal of embedded foreign body from dentoalveolar structures; soft tissues

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.86 / $1,823.00 / $3,363.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.40 / $240.79 / $386.37
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.43 / $1,333.68 / $4,569.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.30 / $517.15 / $2,174.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.61 / $306.61 / $546.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.83 / $928.83 / $928.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.49 / $455.01 / $545.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.72 / $434.30 / $874.48
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.83 / $435.08 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.53 / $462.91 / $656.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.77 / $528.94 / $822.89
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,640.00 / $4,755.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.24 / $735.57 / $2,174.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.00 / $2,338.00 / $4,952.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$210.06 / $449.95 / $1,150.94