go back

Indiana rates for HCPCS L5684

Addition to lower extremity, below knee, fork strap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27.50 / $27.50 / $57.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.50 / $28.21 / $32.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.64 / $51.70 / $57.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $35.13 / $48.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.33 / $63.55 / $86.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$49.10 / $63.55 / $77.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.36 / $37.36 / $57.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.27 / $37.36 / $59.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.21 / $28.82 / $43.42