go back

Massachusetts rates for HCPCS L5859

Addition To Lower Extremity Prosthesis Endoskeletal Knee-Shin System Powered And Programmable Flexion/Extension Assist Control Includes Any Type Motor(S)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,469.69 / $7,469.69 / $7,469.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,469.69 / $8,086.10 / $13,603.77
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,514.22 / $35,557.11 / $81,836.25
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,948.84 / $12,169.09 / $16,695.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $9,812.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $20,306.25
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
$13,841.85 / $13,841.85 / $14,533.94
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35,557.11 / $81,836.25 / $81,836.25
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,678.12 / $10,598.45 / $16,695.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,508.88 / $10,598.45 / $16,695.29