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Arkansas rates for HCPCS L5654

Addition to lower extremity, socket insert, Symes, (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$262.99 / $262.99 / $262.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.47 / $262.99 / $262.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.46 / $540.61 / $600.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.05 / $398.05 / $398.05
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.05 / $398.05 / $398.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.16 / $306.16 / $378.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.50 / $306.16 / $369.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.38 / $236.05 / $314.95