go back

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
$369.98 / $547.27 / $564.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.96 / $423.94 / $770.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$809.82 / $850.31 / $3,738.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.11 / $373.72 / $655.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.18 / $452.18 / $452.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.09 / $330.09 / $482.05
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$342.62 / $632.48 / $3,241.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.33 / $405.14 / $652.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$819.40 / $819.40 / $983.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.33 / $404.01 / $541.08