go back

Alabama rates for HCPCS L5655

Addition To Lower Extremity Socket Insert Below Knee (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$283.56 / $283.56 / $283.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.02 / $283.56 / $283.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.49 / $223.49 / $223.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.07 / $221.07 / $341.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.38 / $221.07 / $299.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.88 / $168.29 / $244.74