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Maryland rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,023.07 / $2,311.77 / $3,769.33
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,631.91 / $2,631.91 / $3,222.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,886.72 / $2,886.72 / $2,886.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,107.31 / $2,886.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,300.14 / $4,714.47 / $6,788.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,123.65 / $2,432.91 / $3,729.63
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,611.05 / $2,611.05 / $3,300.14