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Connecticut rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,202.26 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $1,174.90 / $1,778.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,511.89 / $3,090.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,202.26 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,698.24 / $2,137.96
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,174.90 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $776.25 / $1,230.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,230.27 / $1,621.81