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New Mexico rates for HCPCS L5642

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$423.09 / $423.09 / $423.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$423.09 / $577.54 / $2,145.54
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 / $1,007.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.56 / $766.96 / $1,150.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.50 / $239.50 / $576.37
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $530.41 / $1,161.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.97 / $370.99 / $567.71