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Washington, DC rates for HCPCS L5683

Addition To Lower Extremity Below Knee/Above Knee Custom Fabricated Socket Insert For Other Than Congenital Or Atypical Traumatic Amputee Siliconegel Elastomeric Or Equal For Use With Or Without Locking Mechanism Initial Only(For Other Than I Nitial Use Code L5673 Or L5679)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$826.12 / $826.12 / $826.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.12 / $826.12 / $826.12
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$865.24 / $865.24 / $1,059.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.88 / $693.88 / $693.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.44 / $1,007.44 / $3,076.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.48 / $773.22 / $1,095.40