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New York rates for HCPCS L5649

Addition to lower extremity, ischial containment/narrow M-L socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$839.77 / $994.47 / $1,840.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.77 / $1,071.32 / $1,440.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,285.19 / $2,330.89 / $4,570.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,711.10 / $1,711.10 / $3,933.44
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,770.62 / $1,903.89 / $1,903.89
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,903.89 / $1,903.89 / $1,903.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,800.00 / $1,800.00 / $1,800.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,314.00 / $1,314.00 / $1,800.00
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $2,285.19 / $5,141.68
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,293.44 / $1,691.04 / $4,113.34
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,616.80 / $1,616.80 / $1,616.80
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.86 / $1,459.73 / $1,903.89
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,853.59 / $1,853.59 / $1,853.59
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $1,800.00 / $2,285.19
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,314.00 / $1,361.45 / $3,459.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$760.04 / $1,406.73 / $2,090.10
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,373.86 / $1,373.86 / $1,427.70
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,373.86 / $1,373.86 / $1,616.80