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Massachusetts rates for HCPCS A4928

Surgical mask, for dialysis, per 20

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.25 / $1.25 / $1.25
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.30 / $0.30 / $0.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.00 / $17.00 / $17.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.23 / $2.23 / $2.23
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.88 / $23.88 / $23.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.23 / $2.23 / $2.23