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Michigan rates for HCPCS L5688

Addition to lower extremity, below knee (BK), waist belt, webbing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.14 / $42.14 / $42.14
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$35.95 / $42.14 / $42.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.70 / $222.55 / $405.34
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.11 / $73.80 / $99.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.66 / $47.66 / $47.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.04 / $59.04 / $59.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.81 / $45.81 / $45.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.81 / $45.81 / $85.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.14 / $53.32 / $53.32
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.14 / $53.32 / $81.05
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.78 / $54.61 / $62.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $36.58 / $56.36