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Massachusetts rates for HCPCS A4355

Irrigation Tubing Set For Continuous Bladder Irrigation Through A Three-Way Indwelling Foley Catheter Each (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.63 / $4.63 / $4.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.63 / $4.63 / $9.31
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.48 / $25.29 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.76 / $8.13 / $11.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.83 / $6.83 / $20.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.68 / $6.93 / $6.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.85 / $5.85 / $7.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.97 / $5.08 / $9.25
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.64 / $8.64 / $9.07
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $4.95 / $4.95
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.29 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.07 / $5.29 / $14.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.13 / $6.06 / $11.93