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Washington, DC rates for HCPCS L5697

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Band

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.05 / $54.05 / $54.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.05 / $54.05 / $54.05
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.00 / $56.83 / $69.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $43.95 / $43.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.91 / $65.91 / $201.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.72 / $50.59 / $71.66