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Massachusetts rates for HCPCS L3255

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23.50 / $23.50 / $23.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.57 / $23.50 / $24.00
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
$23.72 / $23.72 / $23.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.32 / $22.04 / $23.72
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