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Maryland rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$601.03 / $686.89 / $1,147.97
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.00 / $691.00 / $880.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $908.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $662.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$902.08 / $1,288.69 / $1,855.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.75 / $726.35 / $1,019.48
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$779.80 / $779.80 / $902.08