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Massachusetts rates for HCPCS L5814

Addition, endoskeletal knee-shin system, polycentric, hydraulic swing phase control, mechanical stance phase lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.96 / $1,911.96 / $1,911.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,911.96 / $2,016.55 / $3,482.09
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,850.46 / $8,990.35 / $20,912.72
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,998.13 / $3,155.31 / $4,273.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,644.58 / $5,650.66 / $7,276.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,151.93 / $3,882.66 / $3,882.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,502.67 / $2,528.88 / $3,067.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,826.95 / $2,502.67 / $5,197.50
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
$3,542.98 / $3,542.98 / $3,720.13
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,613.71 / $2,613.71 / $2,613.71
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,101.40 / $20,912.72 / $20,912.72
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,709.34 / $2,339.10 / $4,273.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.70 / $2,346.78 / $4,273.35