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Massachusetts rates for HCPCS Q4257

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.09 / $915.09 / $915.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $951.69
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.09 / $2,153.31 / $3,031.69
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $2,296.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.09 / $915.09 / $915.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $915.09
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$915.09 / $1,374.92 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$714.12 / $777.83 / $840.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $915.09
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,417.80 / $1,417.80 / $2,153.31
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $2,296.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.09 / $915.09 / $1,533.84