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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
$1,995.26 / $1,995.26 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,995.26 / $3,981.07
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,677.35 / $20,892.96
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $3,235.94 / $4,677.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $5,888.44 / $7,762.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,981.07 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,630.27 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $2,238.72
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $6,025.60
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,630.27
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,677.35 / $20,892.96
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $3,235.94 / $5,128.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.69 / $2,570.40 / $4,570.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,570.40 / $3,981.07