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North Carolina rates for HCPCS L5637

Addition to lower extremity, below knee (BK), total contact

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $257.04 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $229.09 / $269.15
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $263.03 / $316.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.40 / $346.74 / $691.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $263.03 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$154.88 / $234.42 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $169.82 / $275.42
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $229.09 / $275.42
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $295.12 / $524.81
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $0.60 / $0.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $263.03 / $275.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $173.78 / $269.15
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $2,187.76
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $3,311.31