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Nebraska 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
$336.31 / $336.31 / $336.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.31 / $336.31 / $396.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.50 / $509.85 / $515.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $580.10 / $580.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.53 / $580.10 / $894.52
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.68 / $577.24 / $2,777.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.78 / $347.66 / $515.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$578.41 / $580.10 / $801.14
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$482.34 / $685.57 / $1,195.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.78 / $326.20 / $405.42