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Arkansas rates for HCPCS L5656

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $251.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $251.19 / $389.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $245.47 / $338.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $512.86 / $602.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $223.87 / $338.84