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Louisiana 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
$862.80 / $915.90 / $1,300.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$698.94 / $915.90 / $1,327.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.51 / $2,373.77 / $3,336.66
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.60 / $1,133.45 / $1,133.45
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $950.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.92 / $827.81 / $1,090.83