go back

Massachusetts rates for HCPCS L5658

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

Facilitymedian $295 · 10th–90th $219–$1,5140%20%10th90th$295Professionalmedian $331 · 10th–90th $200–$5010%20%10th90th$331$0.5$5.0$50.0$500.0$5.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $218.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $251.19 / $457.09
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $501.19 / $2,344.23
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $389.05 / $575.44
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $389.05
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $3,630.78 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $676.08
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $275.42
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $501.19 / $2,344.23
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $389.05 / $575.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $331.13 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $338.84 / $446.68