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Massachusetts rates for HCPCS L5990

Addition to lower extremity prosthesis, user adjustable heel height

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,071.52 / $1,949.84
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,187.76 / $10,232.93
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,584.89 / $2,187.76
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,818.38 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,905.46 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,318.26
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $4,897.79 / $9,772.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $2,818.38
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,659.59 / $1,659.59
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,187.76 / $10,232.93
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,621.81 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.55 / $1,479.11 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,479.11 / $1,862.09