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Massachusetts rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $7,244 · 10th–90th $2,570–$10,4710%20%10th90th$7,244Professionalmedian $3,631 · 10th–90th $2,291–$5,7540%20%10th90th$3,631$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $2,570.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,691.53 / $4,570.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $6,025.60 / $26,302.68
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,570.88 / $6,760.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $7,762.47 / $10,232.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,548.13 / $4,168.69
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,801.89
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $7,762.47
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,235.94 / $3,235.94
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $6,025.60 / $26,302.68
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,570.88 / $6,760.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,630.78 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,715.35 / $5,248.07