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Massachusetts rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$748.54 / $748.54 / $748.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.54 / $748.54 / $1,235.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,532.83 / $4,880.35 / $8,041.61
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.73 / $1,115.80 / $1,939.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,818.40 / $2,212.29 / $2,849.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,234.00 / $1,440.09 / $1,440.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$990.95 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,232.20 / $2,103.00
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
$1,387.11 / $1,387.11 / $1,456.47
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,232.76 / $1,232.76 / $1,232.76
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,682.28 / $8,041.61 / $8,041.61
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.23 / $915.77 / $1,673.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.73 / $915.77 / $1,640.08