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Indiana rates for HCPCS L5647

Addition to lower extremity, below knee (BK), suction socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.37 / $454.37 / $954.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.37 / $466.19 / $530.91
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$668.33 / $668.33 / $716.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$754.25 / $854.50 / $954.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$465.75 / $581.25 / $787.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.06 / $1,050.23 / $1,432.13
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$811.54 / $1,050.23 / $1,288.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$596.58 / $596.58 / $954.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $435.50 / $979.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.41 / $717.65 / $755.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.54 / $476.31 / $717.65