go back

Maryland rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,123.39 / $2,593.44 / $4,054.84
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,719.00 / $2,842.14 / $3,466.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,578.08 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $2,612.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,550.11 / $5,071.58 / $7,303.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,372.10 / $2,542.96 / $4,012.15
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,924.35 / $2,924.35 / $3,550.11