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Oregon rates for HCPCS L5677

Additions To Lower Extremity Below Knee Knee Joints Polycentric Pair

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$256.38 / $392.27 / $2,276.60
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 / $292.57 / $400.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.49 / $1,253.52 / $1,634.92
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.27 / $537.41 / $644.98
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$479.58 / $606.28 / $677.23
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$511.98 / $591.78 / $650.96
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.48 / $644.98 / $644.98
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$392.27 / $557.92 / $677.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.57 / $564.77 / $709.48
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.36 / $1,072.58 / $2,262.81
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.67 / $709.48 / $709.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.07 / $295.24 / $563.27