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Connecticut rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $389.05 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $758.58 / $912.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $478.63 / $489.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.63 / $478.63 / $478.63
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $575.44 / $851.14
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $467.74 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $309.03 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $371.54 / $575.44