go back

Massachusetts rates for HCPCS Q4254

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $355.88 / $355.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $370.11
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.00 / $456.00 / $960.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $1,824.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
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
$355.88 / $355.88 / $355.88
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.00 / $456.00 / $960.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$480.00 / $480.00 / $1,824.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $480.00 / $720.00