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Massachusetts rates for HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$961.72 / $961.72 / $961.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.72 / $961.72 / $1,239.35
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,175.00 / $3,831.58 / $10,066.52
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.80 / $1,493.44 / $2,149.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,336.23 / $2,842.30 / $3,660.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,441.29 / $1,696.87 / $1,696.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,273.15 / $1,543.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.40 / $2,188.13
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
$1,782.13 / $1,782.13 / $1,871.24
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,444.15 / $1,444.15 / $1,444.15
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,831.58 / $10,066.52 / $10,066.52
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.70 / $1,098.09 / $2,149.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.07 / $1,098.09 / $2,149.51