go back

Missouri rates for HCPCS L5652

Addition To Lower Extremity Suction Suspension Above Knee Or Knee Disarticulation Socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.07 / $353.63 / $364.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.07 / $273.94 / $498.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.60 / $350.60 / $392.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$523.28 / $549.44 / $2,415.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.48 / $317.41 / $423.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.50 / $338.50 / $338.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.11 / $247.11 / $360.86
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.07 / $421.72 / $2,725.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.55 / $282.82 / $515.16
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.66 / $561.66 / $561.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.41 / $261.06 / $402.28