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Alabama rates for HCPCS L5658

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.84 / $366.84 / $366.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.32 / $366.84 / $366.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.14 / $289.14 / $289.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.26 / $366.26 / $547.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.37 / $366.26 / $479.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $217.72 / $335.50