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Massachusetts rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.33 / $335.33 / $335.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $373.02 / $626.37
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$421.81 / $1,310.41 / $4,423.43
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.75 / $590.01 / $749.49
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.92 / $443.92 / $1,318.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.55 / $680.96 / $680.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$564.09 / $572.20 / $4,439.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $572.20 / $1,025.25
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
$621.39 / $621.39 / $652.46
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.60 / $487.60 / $487.60
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,795.58 / $4,423.43 / $4,423.43
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.22 / $410.25 / $749.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.33 / $449.69 / $749.49