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Rhode Island rates for HCPCS L5697

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Band

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.13 / $57.87 / $76.20
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.64 / $245.33 / $290.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.49 / $72.34 / $116.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.21 / $60.21 / $74.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $60.21 / $60.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.93 / $72.34 / $106.82