go back

Michigan rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.77 / $444.77 / $444.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.42 / $444.77 / $444.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.78 / $2,348.58 / $4,277.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.87 / $778.81 / $1,051.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.67 / $392.60 / $506.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.04 / $623.04 / $623.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.81 / $503.81 / $503.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.78 / $647.57 / $1,128.75
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.77 / $562.82 / $562.82
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$430.29 / $562.82 / $817.75
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$472.58 / $576.32 / $662.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.77 / $388.77 / $388.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.84 / $372.32 / $520.39