go back

Massachusetts rates for HCPCS 80375

Drug/Substance Definitive Qual/Quant Nos 1-3

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.02 / $0.04 / $99.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.00 / $129.00 / $129.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.56 / $135.76 / $135.76
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.52 / $17.28 / $38.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21.29 / $52.96 / $95.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.95 / $14.95 / $14.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.56 / $0.99 / $1.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.57 / $23.95 / $107.77
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.54 / $34.54 / $40.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.53 / $29.84 / $72.03
Health New England
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.65 / $29.61 / $35.34
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.56 / $135.76 / $135.76
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.77 / $17.28 / $38.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.24 / $17.28 / $37.56