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Massachusetts rates for HCPCS B4083

Stomach Tube - Levine Type (Special Coverage Instructions Apply. See Cim: 65-10 And Mcm: 2130 4450)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.21 / $1.21 / $1.31
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.94 / $2.17 / $85.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.13 / $1.94 / $3.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.18 / $1.18 / $1.65
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.00 / $3,504.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.80 / $1.80 / $3.74
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $85.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $2.34 / $4.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.12 / $1.94 / $3.79