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Michigan rates for HCPCS L5694

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

Facilitymedian $275 · 10th–90th $123–$8710%10%10th90th$275Professionalmedian $126 · 10th–90th $93–$2190%20%10th90th$126$0.2$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $123.03 / $186.21
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $660.69 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $229.09
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $141.25 / $269.15
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $416.87 / $467.74
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $269.15
Priority Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $151.36 / $245.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $177.83 / $295.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $109.65 / $165.96