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Missouri 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
$198.71 / $293.93 / $303.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.71 / $231.83 / $413.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.94 / $456.69 / $2,007.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.34 / $263.39 / $351.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.77 / $271.77 / $271.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.39 / $198.39 / $289.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.71 / $350.52 / $2,350.53
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.82 / $235.07 / $453.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.82 / $218.63 / $425.68