go back

Texas 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
$297.29 / $297.29 / $321.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.29 / $321.07 / $594.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$404.31 / $404.31 / $404.31
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.02 / $679.02 / $679.02
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 / $318.98 / $436.96
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.76 / $3,169.20 / $3,169.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,390.18 / $3,390.18 / $5,043.68
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.58 / $473.22 / $679.02
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.79 / $611.12 / $679.02
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$195.58 / $453.71 / $679.02
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.98 / $318.98 / $450.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.47 / $373.48 / $456.47
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.46 / $405.82 / $679.02