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Kansas 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
$395.09 / $395.09 / $395.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.55 / $275.07 / $440.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.35 / $438.98 / $465.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.72 / $435.72 / $435.72
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 / $366.26 / $794.06
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.55 / $423.46 / $2,323.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $291.58 / $671.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.76 / $262.13 / $351.07