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Washington, DC rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.29 / $119.29 / $119.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.29 / $119.29 / $119.29
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.00 / $125.41 / $152.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.07 / $124.07 / $124.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.46 / $145.46 / $444.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.43 / $111.65 / $169.83