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Massachusetts rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.98 / $3.98 / $3.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.98 / $7.08 / $21.38
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $10.96 / $79.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $8.71 / $15.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6.92 / $6.92 / $20.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.76 / $6.92 / $6.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.75 / $6.03 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.50 / $6.31 / $7.59
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.33 / $9.33 / $14.13
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.31 / $3.31 / $3.31
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.91 / $10.96 / $79.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.79 / $8.71 / $16.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.07 / $4.90 / $6.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.47 / $6.46 / $10.47