go back

Indiana rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.90 / $75.90 / $159.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.90 / $77.88 / $88.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.99 / $142.72 / $159.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.91 / $96.39 / $130.12
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.61 / $175.43 / $239.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.56 / $175.43 / $215.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.66 / $99.66 / $159.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.75 / $99.66 / $163.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.04 / $79.56 / $119.88