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North Carolina 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
$1,990.34 / $1,990.34 / $3,433.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$964.36 / $1,990.34 / $1,990.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,070.71 / $3,371.70 / $4,152.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,582.48 / $1,704.76 / $1,704.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,179.41 / $1,406.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.41 / $2,188.13
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.91 / $1,980.10 / $2,587.44
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,278.00 / $1,278.00 / $1,545.51
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,911.30 / $2,911.30 / $4,476.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.70 / $1,098.58 / $1,601.13
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,639.14 / $10,066.52 / $10,066.52
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,532.82 / $12,532.82 / $18,195.68