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Maryland rates for HCPCS L5643

Addition To Lower Extremity Hip Disarticulation Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$778.20 / $995.73 / $1,493.59
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.00 / $1,046.90 / $1,277.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,167.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $852.13 / $1,167.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,307.67 / $1,868.10 / $2,690.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.49 / $964.04 / $1,477.86
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,130.41 / $1,130.41 / $1,307.67