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Arkansas rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$282.68 / $282.68 / $282.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.36 / $282.68 / $282.68
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.86 / $406.86 / $406.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.04 / $581.09 / $645.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$381.43 / $381.43 / $494.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$494.32 / $494.32 / $494.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.05 / $248.05 / $406.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.08 / $248.05 / $397.32
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.89 / $467.89 / $467.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.58 / $251.46 / $303.11