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Mississippi 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
$122.02 / $122.02 / $190.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.54 / $182.38 / $236.57
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.73 / $168.73 / $168.73
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.73 / $168.73 / $168.73
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 / $207.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.42 / $108.63 / $167.39