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Louisiana 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
$1,085.91 / $1,152.73 / $1,637.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$879.67 / $1,152.73 / $1,670.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.82 / $2,987.59 / $4,199.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,192.61 / $1,426.54 / $1,426.54
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,167.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,167.30 / $1,167.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.32 / $1,002.38 / $1,436.15