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North Carolina rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.45 / $505.45 / $1,025.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.80 / $505.45 / $505.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.67 / $1,007.36 / $1,240.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.09 / $509.33 / $509.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.96 / $436.96 / $436.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.98 / $436.96 / $783.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.58 / $505.45 / $764.76
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.00 / $382.00 / $477.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.00 / $807.00 / $1,240.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.30 / $338.80 / $491.25
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.76 / $3,169.20 / $3,169.20
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,390.18 / $3,390.18 / $5,043.68