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Louisiana 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
$246.58 / $261.75 / $371.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.58 / $261.75 / $379.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.10 / $678.39 / $953.57
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.81 / $323.93 / $323.93
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $335.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $601.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.08 / $232.01 / $342.28