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Oklahoma 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
$195.76 / $195.76 / $195.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.76 / $223.72 / $223.97
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.40 / $274.01 / $2,344.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.08 / $293.51 / $461.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.08 / $222.12 / $334.59