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California rates for HCPCS L5668

Addition To Lower Extremity Below Knee Molded Distal Cushion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.79 / $72.79 / $466.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.63 / $72.79 / $466.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.28 / $227.74 / $513.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.26 / $80.98 / $128.21
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.60 / $191.33 / $341.66
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.34 / $214.43 / $499.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.59 / $89.19 / $89.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.11 / $65.11 / $95.08
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.80 / $70.56 / $177.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.97 / $113.13 / $250.50
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.55 / $645.28 / $767.65
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.97 / $799.97 / $947.55
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.29 / $485.29 / $485.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.04 / $139.66 / $161.61
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.11 / $89.19 / $131.51
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.01 / $305.01 / $305.01
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.80 / $99.96 / $129.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.92 / $68.17 / $153.76