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Massachusetts rates for HCPCS L5656

Addition to lower extremity, socket insert, knee disarticulation (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $194.98 / $194.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $251.19 / $537.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $457.09 / $2,818.38
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $338.84 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $263.03 / $794.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $398.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $331.13 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $338.84
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
$389.05 / $389.05 / $602.56
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $288.40 / $288.40
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $457.09 / $2,818.38
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $346.74 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.35 / $331.13 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $316.23 / $389.05