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Massachusetts rates for HCPCS A4257

Replacement lens shield cartridge for use with laser skin piercing device, each

Facilitymedian $17 · 10th–90th $7–$850%20%40%10th90th$17Professionalmedian $13 · 10th–90th $7–$170%20%10th90th$13$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.08 / $10.96 / $15.85
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $17.78 / $57.54
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $16.98 / $30.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $7.41 / $7.94
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $93.33 / $8,511.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.49 / $15.49 / $15.49
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$16.98 / $17.78 / $57.54
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $16.98 / $30.20
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $18.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $12.88 / $15.49