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Oklahoma rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.72 / $1,301.72 / $1,301.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,301.72 / $1,456.62 / $1,487.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,769.38 / $1,769.38 / $1,769.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,769.38 / $1,769.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$781.11 / $1,822.16 / $12,904.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$806.62 / $1,598.86 / $3,024.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$806.62 / $1,410.61 / $1,822.59