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Maryland rates for HCPCS L5646

Addition To Lower Extremity Below Knee Air Flu Id Gel Or Equal Cushion Socket. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.95 / $350.52 / $513.26
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$353.00 / $368.54 / $449.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$410.92 / $410.92 / $410.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.97 / $299.97 / $410.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.33 / $657.62 / $946.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.23 / $339.37 / $520.24
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.00 / $398.00 / $460.33