go back

Washington, DC rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $1,778.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,778.28 / $2,290.87
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $2,344.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $2,630.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $4,786.30 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,370.32 / $5,370.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,511.89