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Indiana rates for HCPCS L5680

Addition to lower extremity, below knee (BK), thigh lacer, nonmolded

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.86 / $173.86 / $365.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.86 / $178.38 / $203.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$288.60 / $326.95 / $365.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.21 / $221.25 / $300.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$298.36 / $401.85 / $547.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$310.52 / $401.85 / $493.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.28 / $228.28 / $365.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.64 / $228.28 / $374.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.50 / $182.26 / $274.61