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Colorado rates for HCPCS L5628

Addition To Lower Extremity Test Socket Hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$289.75 / $289.75 / $289.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.97 / $289.75 / $519.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$579.49 / $651.11 / $1,182.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$352.40 / $352.40 / $387.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.82 / $499.82 / $499.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.87 / $364.87 / $649.91
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.64 / $319.07 / $724.36
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.64 / $186.64 / $186.64
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.03 / $724.36 / $1,158.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $433.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.30 / $289.10 / $445.50