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Washington, DC rates for HCPCS L1620

Hip Orthosis Abduction Control Of Hip Joints Flexible (Pavlik Harness) Prefabricated Item That Has Been Trimmed Bent Molded Assembled Orotherwise Customized To Fit A Specific Patient By An Individual With Expertise (Revised 01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.26 / $74.26 / $74.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.26 / $74.26 / $74.26
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.00 / $97.00 / $124.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.67 / $85.67 / $85.67
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.94 / $117.94 / $360.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.35 / $90.52 / $136.01