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Massachusetts rates for HCPCS 52317

Litholapaxy Smpl/Sm <2.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$868.45 / $2,094.00 / $3,990.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.79 / $868.45 / $1,467.20
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$815.47 / $3,764.00 / $12,000.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.70 / $1,399.05 / $7,579.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.86 / $508.12 / $998.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$492.44 / $1,204.98 / $2,801.72
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.23 / $712.70 / $6,679.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.16 / $1,040.24 / $1,581.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.60 / $1,039.97 / $2,308.84
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$922.43 / $1,718.81 / $2,798.16
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.91 / $812.91 / $812.91
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,665.68 / $4,249.00 / $12,000.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,030.23 / $2,316.03 / $7,579.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.00 / $3,764.00 / $8,766.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$848.83 / $1,634.20 / $3,318.78