go back

Texas rates for HCPCS L5672

Addition to lower extremity, below knee (BK), removable medial brim suspension

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$156.69 / $156.69 / $169.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.69 / $169.23 / $313.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.11 / $213.11 / $213.11
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$357.90 / $357.90 / $357.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$297.81 / $297.81 / $297.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.40 / $217.40 / $297.81
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,867.83 / $1,908.80 / $1,908.80
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,376.46 / $2,376.46 / $2,684.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.27 / $250.06 / $357.90
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.57 / $329.27 / $387.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.27 / $251.10 / $357.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.40 / $217.40 / $306.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.79 / $220.12 / $269.02
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.57 / $217.64 / $357.90