go back

Indiana rates for HCPCS L5686

Addition to lower extremity, below knee (BK), back check (extension control)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $33.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $33.88 / $48.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $70.79 / $89.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.15 / $38.90 / $70.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.66 / $75.86 / $91.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $44.67 / $70.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.11 / $33.11 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $46.77 / $54.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.42 / $34.67 / $46.77