go back

Oklahoma 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
$1,194.28 / $1,194.28 / $1,194.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,194.28 / $1,253.82 / $1,364.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,620.00 / $1,620.00 / $1,620.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.59 / $1,620.00 / $1,620.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.36 / $1,671.76 / $11,250.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.32 / $1,376.26 / $2,718.23
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
$694.32 / $1,294.18 / $1,569.19