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Massachusetts rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,096.48 / $1,096.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,122.02 / $2,041.74
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,570.40 / $10,000.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,778.28 / $2,570.40
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $3,235.94 / $4,265.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,445.44 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,445.44
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $3,311.31
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,570.40 / $10,000.00
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,905.46 / $2,818.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.48 / $1,412.54 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,412.54 / $2,187.76