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Massachusetts rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.90 / $1,932.00 / $3,469.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.88 / $209.59 / $484.86
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.60 / $1,089.00 / $5,047.31
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.32 / $362.78 / $1,560.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.46 / $208.76 / $372.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.09 / $224.73 / $433.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.49 / $330.49 / $652.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.80 / $318.25 / $628.37
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.15 / $506.00 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.06 / $325.39 / $470.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.17 / $371.99 / $589.72
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
$234.95 / $529.66 / $1,560.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$822.00 / $3,372.00 / $8,459.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.18 / $331.65 / $845.73