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Massachusetts rates for HCPCS L3390

Outflare Wedge (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.47 / $25.47 / $25.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.47 / $27.59 / $37.36
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.25 / $121.31 / $278.23
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.17 / $41.72 / $56.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.99 / $43.99 / $43.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $43.99 / $69.38
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
$47.19 / $47.19 / $49.55
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.06 / $12.06 / $12.06
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.31 / $278.23 / $278.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22.19 / $29.08 / $56.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.04 / $30.16 / $56.92