go back

Wisconsin rates for HCPCS L5686

Addition To Lower Extremity Below Knee Back Check (Extension Control)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$35.04 / $35.04 / $35.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.55 / $35.04 / $58.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.48 / $76.43 / $126.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.53 / $64.62 / $85.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$49.99 / $148.69 / $148.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $143.53 / $289.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.81 / $100.78 / $131.49
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.75 / $52.58 / $79.90
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.77 / $69.48 / $83.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.18 / $69.48 / $328.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.29 / $46.08 / $75.65
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.25 / $58.40 / $85.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.75 / $52.58 / $79.90
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.77 / $69.48 / $83.38
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.48 / $106.92 / $183.68
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.94 / $135.69 / $328.96
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.81 / $44.94 / $392.45
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.48 / $69.48 / $69.48
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.48 / $69.48 / $69.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.24 / $37.24 / $37.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.95 / $40.78 / $59.58