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Massachusetts rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $3,467 · 10th–90th $1,230–$5,1290%20%10th90th$3,467Professionalmedian $1,905 · 10th–90th $1,175–$2,7540%20%10th90th$1,905$2.0$10.0$50.0$200.0$1.0K$5.0K$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
$1,230.27 / $1,230.27 / $1,230.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,412.54 / $2,570.40
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,754.23 / $13,489.63
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,238.72 / $3,162.28
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,187.76
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
$2,454.71 / $2,454.71 / $3,715.35
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $1,949.84 / $1,949.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,754.23 / $13,489.63
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,238.72 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,905.46 / $3,388.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,949.84 / $2,454.71