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North Carolina rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,149.73 / $2,149.73 / $4,362.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,292.08 / $2,149.73 / $2,149.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,315.71 / $2,778.85 / $5,276.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,646.33 / $2,166.21 / $2,166.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $1,786.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,429.31 / $3,818.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.44 / $2,149.73 / $3,411.85
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,624.00 / $1,624.00 / $2,027.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,650.30 / $3,650.30 / $5,612.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.73 / $1,440.94 / $2,203.48
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,533.40 / $15,327.35 / $15,327.35
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,888.66 / $16,888.66 / $22,814.25