go back

New Mexico 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
$2,666.00 / $2,666.00 / $2,666.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,666.00 / $3,639.30 / $18,591.59
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,578.08 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $6,797.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,866.21 / $4,832.77 / $7,249.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.51 / $1,556.51 / $3,631.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $3,578.08 / $6,349.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,229.17 / $2,411.02 / $3,715.30