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Connecticut rates for HCPCS L5677

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $354.81 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $812.83 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $380.19 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $295.12 / $295.12
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $512.86 / $512.86
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $537.03 / $676.08
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $380.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $389.05 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $398.11 / $512.86