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Wisconsin rates for HCPCS L5270

Hip Disarticulation Tilt Table Type; Molded Socket Locking Hip Joint Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,793.86 / $3,793.86 / $3,793.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,582.69 / $3,793.86 / $6,299.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,520.60 / $8,272.66 / $13,687.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,819.87 / $6,994.16 / $9,250.33
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,410.31 / $16,094.08 / $16,094.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,865.01 / $15,547.75 / $31,392.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,551.46 / $10,898.44 / $14,233.33
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,988.15 / $5,690.79 / $8,648.69
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,306.13 / $7,520.60 / $9,024.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,441.57 / $7,520.60 / $33,007.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,387.68 / $4,639.02 / $8,189.02
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $4,207.28
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,988.15 / $5,690.79 / $8,648.69
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,306.13 / $7,520.60 / $9,024.71
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,520.60 / $11,573.96 / $18,478.12
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,865.01 / $14,688.68 / $33,007.53
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,551.46 / $4,865.01 / $46,658.93
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,520.60 / $7,520.60 / $7,520.60
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,520.60 / $7,520.60 / $7,520.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,320.94 / $5,320.94 / $5,320.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,783.41 / $4,634.38 / $6,584.49