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Missouri rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,197.67 / $4,729.89 / $4,881.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,197.67 / $3,664.00 / $6,661.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,999.07 / $7,349.02 / $32,307.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,428.56 / $3,804.46 / $5,662.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,366.38 / $4,366.38 / $4,366.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,187.46 / $3,187.46 / $4,497.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,197.67 / $5,640.69 / $33,390.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,589.04 / $3,741.26 / $5,962.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,589.04 / $3,518.29 / $5,414.38