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Maryland rates for HCPCS L5782

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,132.77 / $2,437.13 / $3,973.72
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,748.93 / $2,748.93 / $3,397.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.10 / $3,294.10 / $3,294.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,404.69 / $2,404.69 / $3,294.10
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,479.08 / $4,970.12 / $7,156.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.80 / $2,560.84 / $3,931.87
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,752.64 / $2,752.64 / $3,479.08