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Oklahoma 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
$295.01 / $295.01 / $295.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.00 / $295.01 / $337.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.45 / $584.45 / $584.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$490.87 / $602.07 / $602.07
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 / $679.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $412.95 / $3,128.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.88 / $386.28 / $696.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.88 / $322.23 / $440.33