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Oklahoma rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,132.46 / $2,132.46 / $2,132.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,132.46 / $2,437.10 / $2,437.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,351.96 / $4,351.96 / $4,351.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,249.00 / $3,249.00 / $3,249.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $3,249.00 / $3,249.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.50 / $2,985.03 / $22,345.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,401.84 / $2,778.67 / $5,031.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,401.84 / $2,241.02 / $3,167.50