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Rhode Island rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,713.59 / $1,766.63 / $2,326.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,545.00 / $7,489.28 / $8,866.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,561.62 / $2,561.62 / $3,546.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $2,268.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,902.78 / $1,902.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,768.40 / $2,205.23 / $3,260.99