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Washington, DC rates for HCPCS L5679

Addition To Lower Extremity Below Knee/Above Kneecustom Fabricated Fromexisting Mold Or Prefabric Ated Socket Insert Silicone Gel Elastomeric Or Equal Not For Use With Locking Mechanism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$374.54 / $374.54 / $374.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.54 / $374.54 / $374.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.28 / $392.28 / $480.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.24 / $321.24 / $321.24
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.75 / $456.75 / $1,394.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.71 / $350.56 / $496.63