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Washington, DC rates for HCPCS L5656

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $234.42 / $302.00
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $257.04 / $331.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $676.08 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $234.42 / $363.08