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North Carolina rates for HCPCS L5647

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.61 / $710.61 / $1,442.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.11 / $710.61 / $710.61
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.28 / $859.28 / $859.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.46 / $918.56 / $1,744.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$544.21 / $716.06 / $716.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$590.58 / $596.58 / $596.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $472.46 / $1,107.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.50 / $710.61 / $1,075.17
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.00 / $537.00 / $670.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,199.20 / $1,199.20 / $1,843.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.99 / $629.41 / $733.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.95 / $476.31 / $733.98
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,025.45 / $6,046.75 / $6,046.75
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,556.50 / $6,556.50 / $7,495.13