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Massachusetts rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $380 · 10th–90th $288–$1,9500%20%10th90th$380Professionalmedian $447 · 10th–90th $282–$6460%20%10th90th$447$0.5$5.0$50.0$500.0$5.0K$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
$288.40 / $288.40 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $346.74 / $602.56
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $645.65 / $3,162.28
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $501.19 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $380.19 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$380.19 / $478.63 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $512.86
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
$575.44 / $575.44 / $870.96
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $389.05
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $645.65 / $3,162.28
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $501.19 / $741.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $436.52 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $446.68 / $575.44