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Massachusetts rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $5,754 · 10th–90th $2,042–$8,1280%20%10th90th$5,754Professionalmedian $3,236 · 10th–90th $2,042–$4,5710%20%10th90th$3,236$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,398.83 / $4,265.80
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,570.88 / $22,908.68
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $5,370.32
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $6,165.95 / $8,128.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $3,090.30
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
$4,168.69 / $4,168.69 / $6,165.95
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $3,467.37
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,570.88 / $22,908.68
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,715.35 / $5,370.32
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,235.94 / $5,888.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,311.31 / $4,168.69