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Nevada 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
$146.37 / $146.37 / $375.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.37 / $203.31 / $375.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.79 / $451.79 / $451.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.11 / $266.11 / $581.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.60 / $366.26 / $366.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.37 / $345.63 / $390.45
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.24 / $361.43 / $587.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.47 / $241.50 / $335.50