go back

New Mexico 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
$389.05 / $389.05 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $316.23 / $467.74
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $478.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $562.34 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $776.25
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $707.95 / $1,047.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.82 / $446.68 / $645.65
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $239.88 / $630.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $398.11 / $724.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $302.00 / $398.11