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Rhode Island rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $380.19 / $1,071.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,380.38 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $457.09 / $741.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $489.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $436.52 / $776.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $389.05 / $575.44