go back

Missouri rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $354.81 / $851.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $2,089.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $346.74 / $549.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$269.15 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $489.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $467.74 / $1,548.82
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $316.23 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $467.74 / $467.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $295.12 / $436.52