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Nebraska rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $512.86 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $776.25 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $1,023.29 / $1,479.11
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $891.25 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $501.19 / $812.83
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,122.02 / $1,995.26
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $891.25
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,479.11 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $575.44 / $891.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $398.11 / $630.96