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Mississippi 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
$244.56 / $244.56 / $382.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.56 / $355.60 / $458.99
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.18 / $338.18 / $338.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.18 / $338.18 / $338.18
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$145.13 / $217.72 / $335.50