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Oklahoma rates for HCPCS L5638

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.94 / $259.94 / $259.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$259.94 / $297.07 / $298.94
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 / $903.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.13 / $363.87 / $3,083.04
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.27 / $385.08 / $613.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$388.77 / $388.77 / $388.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.27 / $291.41 / $439.06