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Massachusetts rates for HCPCS L3254

Non-Standard Size Or Width (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15.00 / $15.00 / $15.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.05 / $15.00 / $28.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.00 / $90.00 / $149.09
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $47.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.75 / $10.75 / $10.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.85 / $10.75 / $11.07
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
$52.94 / $52.94 / $55.59
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$90.00 / $100.00 / $100.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $52.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.94 / $52.94 / $52.94