go back

Missouri rates for HCPCS L5690

Addition to lower extremity, below knee (BK), waist belt, padded and lined

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $70.79 / $173.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $123.03 / $426.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $70.79 / $112.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $97.72 / $97.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $70.79 / $97.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $95.50 / $309.03
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $64.57 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $95.50 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.71 / $60.26 / $89.13