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Indiana rates for HCPCS L2628

Addition To Lower Extremity Pelvic Control Metal Frame Reciprocating Hip Joint And Cables

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.20 / $934.20 / $1,887.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$898.27 / $970.13 / $1,049.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,491.11 / $1,689.29 / $1,887.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$920.77 / $1,137.16 / $1,569.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,604.36 / $2,076.23 / $2,831.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,604.36 / $2,076.23 / $2,548.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,179.41 / $1,887.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.41 / $1,936.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$627.76 / $941.64 / $1,390.49