go back

Massachusetts rates for HCPCS 42500

Plastic repair of salivary duct, sialodochoplasty; primary or simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $3,019.95 / $4,897.79
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,677.35 / $45,708.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $741.31 / $6,456.54
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $691.83 / $7,079.46
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $3,801.89 / $9,772.37
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $4,677.35 / $45,708.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $3,890.45 / $11,220.18