go back

Alabama rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $363.08 / $602.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $1,047.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $436.52 / $794.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $288.40 / $436.52