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Colorado rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.37 / $121.37 / $121.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.71 / $121.37 / $218.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.74 / $272.74 / $495.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.08 / $132.08 / $142.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.85 / $140.85 / $140.85
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.82 / $102.82 / $252.38
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$70.13 / $121.39 / $303.43
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.13 / $70.13 / $70.13
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.20 / $303.43 / $480.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.43 / $108.63 / $167.39