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Maryland rates for HCPCS L5672

Addition to lower extremity, below knee (BK), removable medial brim suspension

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $223.87 / $316.23
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $316.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $295.12
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $467.74 / $691.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $269.15 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.17 / $234.42 / $354.81
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $218.78 / $389.05