go back

Nebraska 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
$121.97 / $121.97 / $121.97
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.97 / $121.97 / $143.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.09 / $184.91 / $186.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.66 / $210.39 / $210.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.66 / $210.39 / $324.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.82 / $209.36 / $840.48
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.81 / $106.09 / $159.03
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$209.79 / $210.39 / $265.07
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.30 / $245.77 / $433.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.92 / $105.14 / $122.61