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Indiana rates for HCPCS L5676

Additions to lower extremity, below knee (BK), knee joints, single axis, pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.99 / $206.99 / $434.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.99 / $212.37 / $241.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.60 / $389.27 / $434.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.18 / $263.39 / $355.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$326.20 / $478.43 / $652.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.70 / $478.43 / $587.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.77 / $271.77 / $434.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.39 / $271.77 / $446.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.66 / $216.98 / $326.92