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Arkansas rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.59 / $204.59 / $204.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.46 / $204.59 / $204.59
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
$317.76 / $420.57 / $467.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.02 / $337.02 / $337.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$337.02 / $337.02 / $337.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.07 / $221.07 / $294.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.38 / $221.07 / $287.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.88 / $183.64 / $244.74