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Missouri 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
$371.54 / $549.54 / $549.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $371.54 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $831.76 / $2,884.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $389.05 / $758.58
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $457.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $630.96 / $1,819.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $407.38 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $645.65 / $645.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $398.11 / $537.03