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Colorado 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
$250.11 / $250.11 / $250.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.37 / $250.11 / $328.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.21 / $562.04 / $1,020.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.11 / $266.11 / $287.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$366.26 / $366.26 / $366.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.37 / $267.37 / $562.23
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.55 / $250.11 / $625.26
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.55 / $140.55 / $140.55
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.15 / $625.26 / $990.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.30 / $217.72 / $335.50