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Massachusetts rates for HCPCS Q4133

Grafix Prime Grafixpl Prime Stravix And Stravixpl Per Square Centimeter (Desc Rvsd 1/1/19)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $138.74 / $7,724.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $163.41
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $437.59 / $612.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $1,448.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.87 / $170.37 / $312.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $145.86
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.74 / $208.46 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $138.74
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$240.24 / $612.61 / $612.61
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $1,448.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.74 / $138.74 / $239.70