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Louisiana rates for HCPCS L5642

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$414.51 / $440.01 / $624.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.79 / $440.01 / $637.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$667.54 / $1,140.40 / $1,602.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.24 / $544.54 / $544.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.41 / $530.41 / $530.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $950.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.32 / $382.62 / $571.67