go back

South Carolina rates for HCPCS L5650

Additions To Lower Extremity Total Contact Above Knee Or Knee Disarticulation Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.12 / $262.12 / $262.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.12 / $262.12 / $436.11
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.64 / $285.64 / $285.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.00 / $418.44 / $621.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.95 / $379.03 / $418.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $370.90
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.74 / $420.00 / $920.22
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.00 / $329.00 / $354.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.93 / $395.93 / $395.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.83 / $292.32 / $440.44