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Delaware rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $302.00 / $1,380.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $331.13 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $363.08 / $512.86