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Rhode Island rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $407.38 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,479.11 / $1,737.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $389.05 / $794.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $426.58 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $524.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $575.44 / $1,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $467.74 / $616.60