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Massachusetts rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.91 / $324.91 / $324.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.91 / $332.67 / $594.73
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.07 / $1,127.93 / $3,966.04
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.78 / $571.67 / $726.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.13 / $430.13 / $1,277.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.93 / $659.81 / $659.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$430.13 / $530.41 / $530.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $950.63
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
$602.07 / $602.07 / $632.16
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.44 / $472.44 / $472.44
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,664.44 / $3,966.04 / $3,966.04
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.36 / $397.50 / $726.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.97 / $414.59 / $726.20