go back

Georgia rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.39 / $238.39 / $675.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.39 / $338.51 / $426.52
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.26 / $801.16 / $2,100.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.08 / $475.82 / $913.57
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.42 / $648.55 / $1,058.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.42 / $486.42 / $486.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.58 / $493.58 / $493.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $458.97 / $764.79
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.92 / $572.26 / $795.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.33 / $285.49 / $471.02