go back

Nebraska rates for HCPCS L5620

Addition to lower extremity, test socket, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.63 / $216.63 / $216.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.63 / $216.63 / $255.43
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.78 / $254.78 / $254.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.56 / $328.42 / $331.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.59 / $373.67 / $373.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$209.59 / $373.67 / $576.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$179.30 / $371.83 / $1,729.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.33 / $221.96 / $349.49
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.57 / $373.67 / $506.92
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.70 / $441.61 / $769.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.70 / $219.98 / $256.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.33 / $210.15 / $256.52