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Rhode Island rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.89 / $239.07 / $314.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.37 / $1,013.50 / $1,199.85
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.01 / $298.83 / $479.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.16 / $306.16 / $306.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.50 / $306.16 / $306.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.31 / $298.83 / $441.30