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Washington, DC rates for HCPCS L5673

Addition To Lower Extremity Below Knee/Above Kneecustom Fabricated From Existing Mold Or Prefabricated Socket Insert Silicone Gel Elastomeric Or Equal For Use With Locking Mechanism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.46 / $449.46 / $449.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.46 / $449.46 / $449.46
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.75 / $470.75 / $576.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.84 / $365.84 / $365.84
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.11 / $548.11 / $1,673.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.45 / $420.68 / $595.97