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Kansas rates for HCPCS L5679

Addition To Lower Extremity Below Knee/Above Kneecustom Fabricated Fromexisting Mold Or Prefabric Ated Socket Insert Silicone Gel Elastomeric Or Equal Not For Use With Locking Mechanism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.40 / $563.40 / $563.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.25 / $392.24 / $627.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$561.95 / $561.95 / $561.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$584.12 / $614.86 / $654.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.60 / $645.60 / $645.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.05 / $440.05 / $440.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.24 / $440.05 / $1,145.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.25 / $603.82 / $3,490.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.28 / $428.99 / $957.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.20 / $373.79 / $513.79