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Louisiana rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.55 / $332.85 / $472.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.89 / $332.85 / $482.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$504.97 / $862.66 / $1,212.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.36 / $411.91 / $411.91
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.54 / $274.54 / $274.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $200.41 / $559.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.72 / $289.43 / $348.10