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Kansas 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
$1,188.17 / $1,188.17 / $1,188.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.00 / $827.21 / $1,323.53
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.10 / $1,185.10 / $1,185.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,178.29 / $1,240.31 / $1,319.36
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,302.33 / $1,302.33 / $1,302.33
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 / $950.52 / $2,301.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.00 / $1,273.47 / $7,396.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $844.65 / $2,018.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.54 / $788.32 / $1,122.70