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Wisconsin rates for HCPCS L5644

Addition to lower extremity, above knee (AK), wood socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.62 / $357.62 / $357.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.32 / $357.62 / $595.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$708.91 / $779.80 / $1,290.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.01 / $659.29 / $871.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.99 / $1,517.07 / $1,517.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.59 / $1,465.28 / $2,958.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.77 / $1,027.50 / $1,341.68
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.32 / $536.42 / $815.25
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.90 / $708.91 / $850.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.62 / $708.91 / $3,692.24
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.61 / $473.68 / $800.34
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $478.42
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.32 / $547.16 / $815.25
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.90 / $708.91 / $850.69
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.91 / $1,091.00 / $2,121.82
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.59 / $1,384.60 / $3,692.24
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$334.77 / $458.59 / $4,707.20
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.91 / $708.91 / $708.91
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$708.91 / $708.91 / $708.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.42 / $425.35 / $708.91