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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
$1,288.25 / $1,698.24 / $6,025.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $7,762.47 / $9,120.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,570.40 / $4,168.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,290.87 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,380.38 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,238.72 / $3,981.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,089.30 / $3,235.94