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Washington, DC rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,512.89 / $2,512.89 / $2,512.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,512.89 / $2,512.89 / $2,512.89
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,631.91 / $2,631.91 / $3,222.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,107.31 / $2,107.31
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,064.41 / $3,064.41 / $9,358.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,904.03 / $6,904.03 / $6,904.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,568.00 / $2,352.00 / $4,020.01