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Massachusetts rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $170 · 10th–90th $126$8510%20%10th90th$170Professionalmedian $166 · 10th–90th $100$2820%20%10th90th$166$0.2$2.0$20.0$200.0$2.0K$20.0K

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
$125.89 / $125.89 / $125.89
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $125.89 / $213.80
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $281.84 / $1,202.26
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $218.78 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $169.82 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $169.82 / $204.17
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $173.78
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
$251.19 / $251.19 / $380.19
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $281.84 / $1,202.26
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $218.78 / $323.59
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $162.18 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $251.19