go back

Massachusetts rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,703.46 / $3,703.46 / $3,703.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,703.46 / $3,906.04 / $6,744.80
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,583.69 / $22,637.31 / $40,507.83
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.38 / $6,296.59 / $8,277.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,255.02 / $10,945.37 / $14,095.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,363.53 / $7,124.90 / $7,124.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,898.43 / $6,042.00 / $6,042.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $6,042.00 / $10,068.00
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
$6,862.77 / $6,862.77 / $7,205.91
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,902.52 / $5,902.52 / $5,902.52
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,629.34 / $40,507.83 / $40,507.83
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,311.01 / $4,530.84 / $8,277.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,681.31 / $4,545.70 / $8,277.52