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Texas rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$336.02 / $336.02 / $362.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.02 / $365.25 / $672.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.98 / $456.98 / $456.98
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.47 / $767.47 / $767.47
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 / $572.20
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,009.36 / $4,423.43 / $4,423.43
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,096.03 / $5,096.03 / $7,674.75
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.19 / $538.45 / $767.47
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.97 / $706.07 / $1,004.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.19 / $542.35 / $767.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $589.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.07 / $472.01 / $576.89
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$464.41 / $468.88 / $767.47