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Texas rates for HCPCS L5653

Addition to lower extremity, knee disarticulation, expandable wall socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$313.06 / $313.06 / $338.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$313.06 / $338.10 / $626.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.29 / $425.75 / $425.75
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$715.04 / $715.04 / $715.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.76 / $555.76 / $555.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.70 / $405.70 / $555.76
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,703.71 / $3,725.56 / $3,725.56
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,638.32 / $4,638.32 / $5,239.05
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.98 / $511.77 / $715.04
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.52 / $657.84 / $858.53
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$224.98 / $511.77 / $715.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.70 / $405.70 / $592.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.41 / $429.61 / $528.74
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$422.69 / $424.79 / $715.04