go back

Massachusetts rates for HCPCS L5673

Addition to lower extremity, below knee (BK)/above knee (AK), custom fabricated from existing mold or prefabricated, socket insert, silicone gel, elastomeric, or equal, with or without perforations, with or without breathable material, for use with locking mechanism

Facilitymedian $501 · 10th–90th $417–$2,9510%20%40%10th90th$501Professionalmedian $603 · 10th–90th $380–$9330%20%10th90th$603$1.0$10.0$100.0$1.0K$10.0K

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
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $457.09 / $794.33
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $933.25 / $4,265.80
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $691.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $588.84
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
$831.76 / $831.76 / $1,258.93
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $676.08
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $933.25 / $4,265.80
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $741.31 / $1,071.52
Tufts
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $602.56 / $1,096.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $616.60 / $831.76