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Missouri rates for HCPCS L5694

Addition To Lower Extremity Above Knee Pelvic Control Belt Padded And Lined

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.48 / $147.15 / $151.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.48 / $116.06 / $207.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.74 / $228.63 / $1,005.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.60 / $132.08 / $176.23
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 / $102.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.48 / $175.48 / $1,167.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.53 / $117.68 / $232.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.70 / $108.63 / $167.39