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Florida rates for HCPCS L5658

Addition To Lower Extremity Socket Insert Above Knee (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.32 / $200.38 / $229.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.32 / $229.57 / $324.81
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.01 / $312.01 / $392.76
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 / $366.26
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.19 / $290.50 / $290.50
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.99 / $290.50 / $436.40
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.21 / $234.18 / $257.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.40 / $217.72 / $328.04
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.18 / $234.18 / $264.07