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Kentucky rates for HCPCS L5628

Addition To Lower Extremity Test Socket Hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$210.64 / $291.20 / $302.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.00 / $321.89 / $411.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.90 / $611.89 / $643.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.83 / $348.05 / $387.11
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.92 / $862.76 / $1,162.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$611.89 / $826.05 / $1,081.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.82 / $499.82 / $755.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.87 / $499.82 / $3,168.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.77 / $389.97 / $487.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $445.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.51 / $327.14 / $445.50