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Alabama rates for HCPCS L5683

Addition To Lower Extremity Below Knee/Above Knee Custom Fabricated Socket Insert For Other Than Congenital Or Atypical Traumatic Amputee Siliconegel Elastomeric Or Equal For Use With Or Without Locking Mechanism Initial Only(For Other Than I Nitial Use Code L5673 Or L5679)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,342.10 / $1,342.10 / $1,342.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$681.63 / $1,342.10 / $1,342.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.63 / $955.63 / $955.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.52 / $950.52 / $1,587.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.88 / $950.52 / $1,390.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $796.51 / $1,096.53