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Rhode Island rates for HCPCS L5701

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,290.87 / $6,606.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $8,709.64 / $10,000.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,818.38 / $4,570.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $3,162.28 / $5,495.41
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,570.40 / $3,630.78