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Indiana rates for HCPCS L5624

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.37 / $229.37 / $481.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.97 / $233.96 / $242.66
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.38 / $361.48 / $361.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.76 / $431.36 / $481.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.12 / $264.64 / $365.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$361.48 / $530.16 / $674.76
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$409.67 / $530.16 / $650.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $481.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $311.77 / $480.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $240.44 / $340.63