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Massachusetts rates for HCPCS L5971

All lower extremity prostheses, solid ankle cushion heel (SACH) foot, replacement only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.00 / $142.00 / $142.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.04 / $142.00 / $196.42
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.79 / $917.15 / $1,456.68
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.96 / $234.36 / $317.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.11 / $288.38 / $288.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.21 / $159.21 / $159.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.22 / $159.21 / $304.13
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
$263.14 / $263.14 / $276.31
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.90 / $194.90 / $194.90
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$532.33 / $1,456.68 / $1,456.68
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.61 / $173.74 / $317.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.74 / $173.74 / $273.02