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Washington, DC rates for HCPCS L5858

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, stance phase only, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,549.93 / $10,715.19 / $14,791.08
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,182.57 / $13,182.57 / $15,488.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $10,715.19 / $15,488.17
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,454.40 / $31,622.78 / $43,651.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32,359.37 / $32,359.37 / $32,359.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,244.36 / $10,964.78 / $16,595.87