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Maryland rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.01 / $358.28 / $590.92
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.00 / $376.68 / $459.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $420.01 / $420.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $306.61 / $420.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.52 / $672.17 / $967.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.77 / $346.33 / $531.75
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.73 / $406.73 / $470.52