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Missouri rates for HCPCS L2627

Addition to lower extremity, pelvic control, plastic, molded to patient model, reciprocating hip joint and cables

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,011.04 / $1,011.04 / $1,346.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,011.04 / $1,047.80 / $1,599.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,931.31 / $2,027.88 / $8,914.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.07 / $1,176.26 / $1,562.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,206.80 / $1,206.80 / $1,206.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$880.96 / $880.96 / $1,243.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,006.52 / $1,563.21 / $10,169.41
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$798.26 / $963.51 / $2,347.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$742.37 / $963.51 / $1,862.08