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Connecticut 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
$753.30 / $753.30 / $753.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$674.48 / $698.94 / $754.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,201.17 / $1,549.90 / $1,773.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$905.47 / $954.08 / $954.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.52 / $950.52 / $950.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.88 / $693.88 / $950.52
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,007.44 / $1,007.44 / $1,007.44
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.44 / $1,007.44 / $1,425.91
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.49 / $1,131.49 / $1,131.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$590.08 / $773.22 / $1,090.83