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Mississippi 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
$189.04 / $189.04 / $295.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.45 / $283.56 / $299.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$253.00 / $253.00 / $253.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.39 / $261.39 / $261.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.39 / $261.39 / $261.39
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 / $221.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.88 / $168.29 / $266.45