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Massachusetts rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.94 / $161.94 / $161.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.94 / $176.69 / $343.01
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$225.13 / $710.34 / $2,347.59
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.00 / $284.95 / $361.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.41 / $214.41 / $636.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.72 / $328.90 / $328.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.41 / $239.78 / $259.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $429.75
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
$300.12 / $300.12 / $315.13
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.13 / $262.13 / $262.13
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$752.48 / $2,347.59 / $2,347.59
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.21 / $200.12 / $361.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.80 / $198.14 / $361.99