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Florida 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
$92.96 / $99.98 / $114.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.96 / $114.54 / $162.06
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 / $137.82
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$75.31 / $144.94 / $144.94
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.78 / $144.94 / $217.74
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.82 / $87.43 / $96.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.50 / $108.63 / $163.66
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.43 / $87.43 / $131.76