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Missouri 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
$87.38 / $129.26 / $133.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.94 / $100.13 / $182.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$191.26 / $200.82 / $882.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $96.39 / $154.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.66 / $99.66 / $99.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.75 / $72.75 / $106.24
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.38 / $154.13 / $840.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.31 / $102.23 / $170.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.31 / $95.42 / $135.44