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Maryland rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $440.00 / $667.04
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.00 / $447.00 / $467.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $572.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $572.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.00 / $834.29 / $1,201.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.80 / $416.21 / $660.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.41 / $464.41 / $584.00