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Massachusetts rates for HCPCS V2521

Contact Lens Hydrophilic Toric Or Prism Ballast Per Lens (Special Coverage Instructions Apply. See Cim: 45-7 65-1)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.99 / $149.44 / $215.66
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.84 / $221.03 / $331.54
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.06 / $163.19 / $1,375.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.60 / $104.60 / $115.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.56 / $184.56 / $184.56
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.96 / $112.91 / $1,394.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.52 / $112.91 / $221.03