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Georgia 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
$246.52 / $246.52 / $698.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.52 / $354.99 / $419.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.78 / $828.49 / $2,171.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.51 / $492.06 / $944.76
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.01 / $591.78 / $1,159.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.01 / $503.01 / $503.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.78 / $400.78 / $400.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.57 / $400.78 / $772.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.75 / $591.78 / $822.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.45 / $295.24 / $487.08