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Missouri 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
$853.48 / $1,262.44 / $1,302.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.48 / $1,196.95 / $1,778.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,868.10 / $1,961.51 / $8,623.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,038.92 / $1,131.33 / $1,511.38
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 / $852.13 / $1,244.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$853.48 / $1,505.55 / $9,793.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.65 / $1,014.49 / $1,992.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.08 / $931.98 / $1,436.15