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Rhode Island rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,621.81 / $5,128.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $6,606.93 / $7,762.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,187.76 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,737.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $3,801.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,905.46 / $2,818.38