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Maryland rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $67.61 / $112.20
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $85.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $89.13 / $89.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $89.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $123.03 / $186.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $91.20 / $93.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $63.10 / $95.50
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $104.71