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Washington, DC rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $9,120.11 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,413.10 / $7,943.28 / $9,120.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,232.93 / $10,232.93 / $12,022.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $9,772.37 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $10,000.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,220.18 / $24,547.09 / $33,884.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,703.96 / $25,703.96 / $25,703.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $8,709.64 / $12,882.50