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Indiana rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.66 / $332.66 / $698.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.17 / $339.31 / $345.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.20 / $625.60 / $698.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.20 / $373.72 / $515.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$522.37 / $768.19 / $978.59
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$594.14 / $768.89 / $943.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.18 / $452.18 / $698.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.09 / $452.18 / $717.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$983.28 / $983.28 / $983.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.40 / $348.72 / $472.45