go back

Michigan rates for HCPCS L5632

Addition to lower extremity, Symes type, PTB brim design socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.63 / $185.63 / $185.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.63 / $185.63 / $185.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$491.97 / $980.19 / $1,785.25
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.79 / $325.04 / $438.80
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.23 / $191.31 / $211.28
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.02 / $260.02 / $260.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.52 / $166.52 / $166.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.52 / $166.52 / $376.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$185.63 / $234.89 / $234.89
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.03 / $234.89 / $341.29
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.23 / $240.53 / $276.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.80 / $155.38 / $232.63