go back

Texas 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
$288.40 / $288.40 / $309.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $331.13 / $575.44
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $389.05 / $389.05
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $676.08 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $457.09
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,570.88 / $4,570.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $537.03 / $851.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $354.81 / $630.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $338.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $512.86 / $870.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $457.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $457.09 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $380.19 / $467.74
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $676.08