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Missouri rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $158 · 10th–90th $95–$3980%20%10th90th$158Professionalmedian $120 · 10th–90th $89–$1950%20%10th90th$120$0.2$1.0$5.0$20.0$100.0$500.0

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
$89.13 / $131.83 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $114.82 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $120.23 / $181.97
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $199.53
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $128.82
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $123.03
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $436.52
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $104.71 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$128.82 / $158.49 / $158.49
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $97.72 / $151.36