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Rhode Island rates for HCPCS L5990

Addition to lower extremity prosthesis, user adjustable heel height

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,148.15 / $3,311.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $4,265.80 / $5,011.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,380.38 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,513.56 / $2,691.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,288.25 / $1,778.28