go back

Washington, DC rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,112.73 / $1,112.73 / $1,112.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,112.73 / $1,112.73 / $1,112.73
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,119.00 / $1,119.00 / $1,427.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.59 / $1,182.59 / $1,182.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,356.94 / $1,356.94 / $4,144.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.15 / $3,340.15 / $3,340.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.32 / $1,120.60 / $1,780.09