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Michigan rates for HCPCS L5645

Addition To Lower Extremity Below Knee Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$671.63 / $671.63 / $671.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.08 / $671.63 / $671.63
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.04 / $1,176.04 / $1,176.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,780.01 / $3,546.47 / $6,459.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.24 / $1,176.04 / $1,587.65
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.48 / $622.48 / $764.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$940.83 / $940.83 / $940.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.09 / $694.09 / $694.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$694.09 / $694.09 / $1,363.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$671.63 / $849.87 / $849.87
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.08 / $849.87 / $1,234.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$713.62 / $870.27 / $1,000.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.14 / $562.22 / $841.72