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Nebraska 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
$3,081.93 / $3,081.93 / $3,081.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,081.93 / $3,081.93 / $3,633.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,247.55 / $4,672.31 / $4,719.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,578.08 / $5,316.05 / $5,316.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,171.21 / $6,209.87 / $8,197.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,771.15 / $5,289.89 / $25,854.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,839.96 / $3,087.08 / $4,018.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,300.49 / $5,316.05 / $7,341.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,813.28 / $6,368.75 / $10,951.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,839.96 / $2,989.45 / $4,018.36