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Missouri rates for HCPCS L5638

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.86 / $394.73 / $407.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.86 / $385.47 / $555.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$584.11 / $613.32 / $2,696.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$324.85 / $356.85 / $472.57
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 / $367.78 / $416.41
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.20 / $470.76 / $3,083.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.84 / $317.20 / $623.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.77 / $388.77 / $388.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.17 / $291.41 / $449.05