go back

Massachusetts rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.73 / $302.73 / $302.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.73 / $302.73 / $456.74
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.07 / $1,127.93 / $3,114.29
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.95 / $462.95 / $676.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.76 / $400.76 / $1,190.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.06 / $614.77 / $614.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.76 / $493.58 / $493.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $493.58 / $884.63
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
$560.98 / $560.98 / $589.03
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.27 / $518.27 / $518.27
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.91 / $3,114.29 / $3,114.29
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.64 / $370.36 / $676.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$763.01 / $763.01 / $763.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.49 / $370.36 / $615.89