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North Carolina rates for HCPCS L5624

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$324.77 / $324.77 / $659.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.13 / $324.77 / $324.77
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.27 / $392.73 / $392.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.51 / $647.28 / $797.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.73 / $327.27 / $327.27
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 / $311.77 / $558.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.54 / $324.77 / $513.25
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $245.00 / $307.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.00 / $605.00 / $930.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.41 / $218.62 / $341.52
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$872.72 / $2,370.48 / $2,370.48
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,879.96 / $2,879.96 / $3,781.20