go back

New Mexico 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
$379.30 / $379.30 / $379.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.91 / $517.78 / $2,254.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$411.95 / $549.26 / $654.45
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 / $276.69 / $719.87
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$550.07 / $687.59 / $1,031.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $188.72 / $516.71
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $379.03 / $807.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.27 / $334.63 / $447.32