go back

Connecticut rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$853.28 / $853.28 / $853.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.83 / $767.07 / $853.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,360.61 / $1,755.62 / $2,008.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.70 / $1,450.68 / $1,450.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$963.22 / $963.22 / $963.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.15 / $703.15 / $963.22
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,141.15 / $1,141.15 / $1,141.15
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.98 / $1,141.15 / $1,492.28
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.37 / $979.37 / $979.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.41 / $875.86 / $1,185.07