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Massachusetts rates for HCPCS L5828

Addition Endoskeletal Knee-Shin System Single Axis Fluid Swing And Stance Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,974.56 / $1,974.56 / $1,974.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,736.98 / $1,974.56 / $2,849.16
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,051.00 / $7,221.40 / $20,855.07
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,765.32 / $3,051.00 / $4,413.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,796.67 / $5,835.70 / $7,515.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,255.14 / $4,009.79 / $4,009.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,614.00 / $3,168.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $1,546.07 / $4,123.88
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
$3,659.00 / $3,659.00 / $3,841.95
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,534.73 / $2,534.73 / $2,636.79
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,221.40 / $20,855.07 / $20,855.07
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,690.94 / $2,415.69 / $4,413.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,720.58 / $2,415.69 / $4,141.78