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Missouri rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.66 / $542.35 / $559.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.66 / $437.79 / $763.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$802.54 / $842.67 / $3,704.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$443.38 / $468.88 / $649.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $572.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $589.37
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.66 / $646.79 / $4,009.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.07 / $433.75 / $781.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.55 / $403.42 / $590.01