go back

Illinois rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$290.01 / $290.01 / $290.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.67 / $312.32 / $492.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$699.60 / $1,183.59 / $5,041.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.31 / $445.31 / $445.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $644.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $685.92
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$498.05 / $682.09 / $832.66
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$761.72 / $761.72 / $761.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.77 / $472.54 / $496.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.60 / $292.32 / $501.82