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Louisiana rates for HCPCS L5695

Addition To Lower Extremity Above Knee Pelvic Control Sleeve Suspension Neoprene Or Equal Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.05 / $149.72 / $212.66
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.26 / $149.72 / $217.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$260.98 / $260.98 / $260.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.16 / $388.06 / $545.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.91 / $185.30 / $185.30
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.31 / $122.31 / $122.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.29 / $122.31 / $122.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.09 / $130.19 / $156.59