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Maryland rates for HCPCS L5656

Addition To Lower Extremity Socket Insert Knee Disarticulation (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.38 / $250.39 / $393.76
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.00 / $255.00 / $324.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $335.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $245.16
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.33 / $474.76 / $683.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.86 / $236.85 / $375.58
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.42 / $269.42 / $332.33