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Nevada 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
$137.52 / $137.52 / $353.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.52 / $179.64 / $353.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.47 / $424.47 / $424.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.21 / $201.58 / $424.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.07 / $221.07 / $312.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$161.38 / $221.07 / $280.54
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.05 / $339.58 / $551.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.36 / $161.61 / $264.70