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Michigan 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
$334.63 / $334.63 / $875.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.77 / $334.63 / $334.63
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$439.46 / $439.46 / $439.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.86 / $1,766.96 / $3,218.22
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.64 / $585.94 / $791.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.86 / $380.86 / $380.86
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.75 / $468.75 / $468.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $379.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $487.20 / $848.91
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$423.42 / $782.03 / $875.39
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.32 / $423.42 / $615.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.55 / $433.60 / $498.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.60 / $292.32 / $487.20