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North Carolina rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,524.43 / $1,524.43 / $3,093.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.26 / $1,524.43 / $1,524.43
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,865.88 / $3,038.16 / $3,741.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.94 / $1,536.13 / $2,048.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $2,952.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,317.79 / $2,952.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.11 / $1,524.43 / $2,306.51
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,152.00 / $1,152.00 / $1,437.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,385.90 / $2,385.90 / $3,668.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.05 / $1,021.81 / $1,603.04
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,135.39 / $9,502.08 / $9,502.08
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,912.18 / $15,058.23 / $15,058.23