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Massachusetts rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$360.33 / $360.33 / $360.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.41 / $360.33 / $565.03
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$480.53 / $1,492.85 / $4,257.09
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.22 / $545.54 / $805.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.02 / $477.02 / $1,416.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.02 / $731.73 / $731.73
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $477.02 / $578.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $420.01 / $822.38
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
$667.72 / $667.72 / $701.11
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.05 / $427.05 / $427.05
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,532.12 / $4,257.09 / $4,257.09
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.14 / $440.83 / $805.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $440.83 / $805.37