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Colorado 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
$200.10 / $200.10 / $200.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.44 / $200.10 / $356.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.19 / $449.65 / $816.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.07 / $240.07 / $259.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.16 / $306.16 / $306.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.50 / $223.50 / $455.28
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.19 / $221.92 / $500.24
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.19 / $128.19 / $128.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.14 / $500.24 / $800.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.61 / $198.59 / $303.88