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Kansas rates for HCPCS L5628

Addition To Lower Extremity Test Socket Hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.71 / $456.71 / $456.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.64 / $317.97 / $508.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$469.69 / $512.47 / $543.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$508.66 / $508.66 / $508.66
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 / $499.82 / $1,119.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.64 / $489.52 / $3,076.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.74 / $347.78 / $776.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.46 / $435.59 / $607.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.01 / $303.02 / $445.50