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Oklahoma rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $275.42 / $275.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $346.74 / $562.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $562.34 / $562.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $645.65
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $407.38 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $363.08 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $512.86 / $660.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $288.40 / $426.58