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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
$416.87 / $416.87 / $416.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $426.58 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $912.01 / $1,122.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $467.74 / $851.14
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $954.99 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $912.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $724.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $588.84 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $436.52 / $588.84