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North Carolina rates for HCPCS L5595

Preparatory Hip Disarticulation-Hemipelvectomy Pylon No Cover Sach Foot Thermoplastic Or Equal Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,793.86 / $3,793.86 / $7,699.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,280.28 / $3,793.86 / $3,793.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,643.58 / $7,561.08 / $9,311.68
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,905.45 / $3,822.96 / $3,822.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,153.07 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,522.44 / $2,612.00 / $6,412.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.51 / $3,793.86 / $5,740.22
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,866.00 / $2,866.00 / $3,577.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,402.10 / $6,402.10 / $9,843.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,953.78 / $2,553.76 / $4,049.34
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,269.36 / $30,607.53 / $30,607.53
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46,192.50 / $46,192.50 / $46,192.50