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Nebraska rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,507.51 / $1,507.51 / $1,507.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,507.51 / $1,507.51 / $1,777.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,077.65 / $2,285.42 / $2,308.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,620.00 / $2,600.30 / $2,600.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,620.00 / $2,600.30 / $4,009.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,254.67 / $2,587.51 / $11,250.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.00 / $1,388.64 / $1,965.56
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,592.69 / $2,600.30 / $3,276.32
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,309.00 / $3,073.08 / $5,357.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,365.94 / $2,365.94 / $2,365.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$900.00 / $1,179.33 / $1,604.89