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Michigan rates for HCPCS L5653

Addition to lower extremity, knee disarticulation, expandable wall socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.28 / $466.28 / $466.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.53 / $466.28 / $466.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,235.79 / $2,462.17 / $4,484.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$775.66 / $816.48 / $1,102.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$454.05 / $454.05 / $530.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.17 / $653.17 / $653.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.76 / $555.76 / $555.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.76 / $555.76 / $946.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$466.28 / $590.00 / $590.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.96 / $590.00 / $857.30
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.44 / $604.20 / $694.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.41 / $390.32 / $584.34