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Georgia rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.77 / $181.77 / $797.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.77 / $258.11 / $293.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.99 / $322.91 / $327.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.36 / $610.90 / $1,601.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.64 / $362.82 / $696.61
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.91 / $413.29 / $807.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.91 / $370.91 / $370.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $311.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $305.08 / $558.75
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.63 / $436.36 / $605.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $217.69 / $359.16