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Nebraska rates for HCPCS L5637

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.12 / $221.12 / $221.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.12 / $221.12 / $260.72
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.06 / $260.06 / $260.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.75 / $335.22 / $338.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.98 / $381.41 / $381.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.98 / $381.41 / $669.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$199.01 / $380.30 / $1,951.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.01 / $230.64 / $390.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.30 / $381.41 / $526.74
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.34 / $457.12 / $785.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.01 / $172.98 / $271.38