go back

Massachusetts rates for HCPCS Q4121

TheraSkin, per sq cm (add-on, list separately in addition to primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $54.86
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.27 / $58.03 / $213.92
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $213.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.60 / $64.78 / $118.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.00 / $83.35 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $52.75
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.00 / $213.92 / $213.92
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.75 / $52.75 / $213.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.84 / $52.75 / $87.25