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Kansas 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
$478.68 / $478.68 / $478.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.60 / $333.26 / $533.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$376.23 / $410.49 / $435.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.44 / $407.44 / $407.44
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 / $965.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.60 / $513.04 / $3,128.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.82 / $364.50 / $813.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.72 / $317.58 / $454.95