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Nebraska rates for HCPCS L5639

Addition To Lower Extremity Below Knee Wood Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$858.16 / $858.16 / $858.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$858.16 / $858.16 / $1,011.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.73 / $1,301.00 / $1,314.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.50 / $1,480.25 / $1,480.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.50 / $1,480.25 / $2,282.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.34 / $1,472.97 / $7,424.54
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.34 / $859.60 / $1,118.91
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,475.92 / $1,480.25 / $2,044.29
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,339.00 / $1,749.38 / $3,049.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.34 / $671.35 / $1,034.53