go back

Illinois rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.01 / $261.01 / $261.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.01 / $287.66 / $443.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.64 / $1,065.24 / $4,537.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.79 / $400.79 / $400.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $580.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $329.53 / $611.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.26 / $613.78 / $749.27
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$685.57 / $685.57 / $685.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.23 / $397.48 / $417.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.35 / $263.08 / $451.64