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Maryland rates for HCPCS L5629

Addition To Lower Extremity Below Knee Acrylic Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.46 / $602.46 / $602.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.63 / $242.39 / $327.79
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.00 / $265.00 / $337.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.05 / $248.05 / $248.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.08 / $181.08 / $248.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.02 / $494.32 / $711.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.30 / $253.73 / $391.06
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.81 / $230.81 / $346.02