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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
$245.47 / $245.47 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $263.03 / $457.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $269.15 / $363.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $346.74 / $588.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $213.80 / $338.84