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Oklahoma rates for HCPCS L5622

Addition To Lower Extremity Test Socket Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.92 / $248.92 / $248.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.92 / $261.33 / $284.49
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.14 / $493.14 / $493.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.67 / $508.01 / $508.01
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.13 / $348.45 / $2,359.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.72 / $286.86 / $566.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.72 / $239.29 / $327.07