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Massachusetts rates for HCPCS A5113

Leg Strap; Latex Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.73 / $2.73 / $2.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.73 / $2.73 / $4.90
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.28 / $13.36 / $80.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.50 / $4.28 / $6.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.01 / $4.01 / $11.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.09 / $4.09 / $4.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.00 / $3.96 / $3.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.37 / $3.96 / $7.50
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
$5.08 / $5.08 / $5.33
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.76 / $3.76 / $3.76
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.36 / $80.00 / $80.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.15 / $3.11 / $8.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.15 / $3.11 / $6.58