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Washington, DC rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,290.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,089.30 / $2,951.21
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $3,019.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $6,165.95 / $8,511.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,137.96 / $3,235.94