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Oklahoma rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,278.01 / $1,278.01 / $1,278.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,278.01 / $1,460.59 / $1,496.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,608.19 / $2,608.19 / $2,608.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $1,902.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,902.78 / $1,902.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.36 / $1,788.98 / $15,444.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.30 / $1,939.14 / $3,015.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.30 / $1,467.45 / $2,210.50