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Oklahoma rates for HCPCS L5652

Addition to lower extremity, suction suspension, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.94 / $261.94 / $261.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.93 / $261.94 / $299.36
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.92 / $518.92 / $518.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.85 / $534.57 / $534.57
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 / $338.50 / $338.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.53 / $366.66 / $2,725.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.04 / $344.98 / $618.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.04 / $278.45 / $393.25