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Oklahoma 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
$870.96 / $870.96 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,122.02 / $1,778.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,778.28 / $1,778.28
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 / $2,041.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,258.93 / $6,165.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,148.15 / $2,630.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $1,621.81 / $2,137.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $933.25 / $1,412.54