go back

Missouri rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $446.68 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $398.11 / $954.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $2,344.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $398.11 / $616.60
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $407.38 / $407.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $407.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $524.81 / $1,513.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $354.81 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $524.81 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $331.13 / $501.19