go back

Mississippi 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
$398.54 / $398.54 / $622.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.08 / $597.07 / $662.27
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.38 / $533.38 / $568.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.90 / $676.90 / $676.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.90 / $676.90 / $676.90
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 / $321.24 / $440.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.28 / $354.79 / $513.79