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North Carolina 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
$1,390.41 / $1,390.41 / $2,821.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.70 / $1,390.41 / $1,390.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,701.82 / $2,771.06 / $3,412.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,300.57 / $1,401.07 / $1,401.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,155.57 / $1,167.30 / $1,167.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,167.30 / $2,803.50
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.66 / $1,390.41 / $2,103.73
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,050.00 / $1,050.00 / $1,311.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,241.69 / $2,241.69 / $3,446.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$716.04 / $931.98 / $1,436.15
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,062.84 / $9,963.20 / $9,963.20
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,404.18 / $12,404.18 / $14,010.75