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Illinois rates for HCPCS L5637

Addition To Lower Extremity Below Knee Total Contact

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.82 / $228.82 / $228.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.43 / $228.82 / $291.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$551.73 / $933.43 / $3,977.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.36 / $351.36 / $365.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.98 / $232.98 / $381.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.08 / $232.98 / $535.88
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.85 / $469.56 / $647.15
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
$601.00 / $601.00 / $601.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.99 / $372.85 / $391.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.94 / $228.59 / $408.41