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Indiana rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.95 / $420.95 / $884.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.85 / $426.78 / $437.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$698.77 / $791.65 / $884.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.16 / $468.88 / $647.04
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.35 / $959.34 / $1,238.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$751.84 / $972.97 / $1,194.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $884.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $572.20 / $882.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.26 / $441.28 / $591.03