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Rhode Island 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
$812.83 / $1,202.26 / $3,801.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $4,897.79 / $5,754.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,412.54 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,445.44 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,348.96 / $2,089.30