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Colorado 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
$159.18 / $159.18 / $159.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.52 / $159.18 / $277.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.35 / $357.70 / $649.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.58 / $201.58 / $217.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.07 / $221.07 / $221.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.38 / $161.38 / $340.64
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.53 / $177.49 / $397.94
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.53 / $102.53 / $102.53
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.40 / $397.94 / $636.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.84 / $158.83 / $244.74