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Maryland rates for HCPCS L5707

Custom Shaped Protective Cover Hip Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.58 / $830.58 / $1,354.26
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$908.00 / $949.23 / $1,157.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $899.51 / $1,232.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.68 / $1,693.83 / $2,439.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$740.73 / $874.10 / $1,339.99
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.44 / $898.44 / $1,185.68