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Missouri 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
$38.90 / $57.55 / $59.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.52 / $44.58 / $81.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.16 / $89.42 / $393.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.55 / $44.58 / $68.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$45.81 / $45.81 / $45.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.44 / $33.44 / $48.83
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $68.62 / $392.56
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.48 / $45.51 / $73.73
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.80 / $84.80 / $84.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.32 / $42.48 / $60.30