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Massachusetts rates for HCPCS L5647

Addition to lower extremity, below knee (BK), suction socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.20 / $556.20 / $556.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$466.19 / $556.20 / $802.57
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$966.15 / $2,025.45 / $6,046.75
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.26 / $966.10 / $1,243.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,351.15 / $1,643.83 / $2,116.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.93 / $1,129.50 / $1,129.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$596.58 / $735.67 / $892.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $435.50 / $1,107.00
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
$1,030.69 / $1,030.69 / $1,082.22
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.58 / $606.58 / $606.58
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,025.45 / $6,046.75 / $6,046.75
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.31 / $680.46 / $1,243.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.76 / $629.41 / $717.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$476.31 / $680.46 / $1,030.69