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Massachusetts rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$557.16 / $557.16 / $557.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.16 / $557.16 / $936.88
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,140.92 / $3,598.46 / $5,705.72
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.83 / $919.49 / $1,245.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,353.48 / $1,646.67 / $2,120.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.01 / $1,131.46 / $1,131.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$737.60 / $937.25 / $957.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $1,565.25
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,032.47 / $1,032.47 / $1,084.08
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.93 / $715.93 / $715.93
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,740.74 / $5,705.72 / $5,705.72
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.12 / $681.64 / $1,245.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.23 / $595.23 / $595.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$527.07 / $681.64 / $1,220.75