go back

Maryland rates for HCPCS L2628

Addition To Lower Extremity Pelvic Control Metal Frame Reciprocating Hip Joint And Cables

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.55 / $961.72 / $1,565.34
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.00 / $1,074.00 / $1,368.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,179.41 / $1,179.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $860.97 / $1,179.41
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,401.68 / $2,002.40 / $2,883.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.07 / $998.98 / $1,592.37
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,130.79 / $1,130.79 / $1,401.68