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Missouri rates for HCPCS L2630

Addition to lower extremity, pelvic control, band and belt, unilateral

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.04 / $146.04 / $194.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.38 / $151.35 / $231.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$278.97 / $292.92 / $1,287.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.40 / $169.99 / $225.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.32 / $174.32 / $174.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.25 / $127.25 / $185.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$146.04 / $225.80 / $1,530.87
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.31 / $139.18 / $339.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.23 / $139.18 / $247.91