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Oklahoma 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
$301.69 / $301.69 / $301.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.68 / $301.69 / $344.79
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.67 / $597.67 / $597.67
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$502.00 / $615.70 / $615.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $329.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $329.53 / $415.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.85 / $422.31 / $2,777.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.40 / $347.66 / $686.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.40 / $317.05 / $396.41