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Nebraska 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
$124.82 / $124.82 / $124.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.82 / $124.82 / $147.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$172.03 / $189.24 / $191.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.31 / $215.30 / $215.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.31 / $215.30 / $332.01
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.34 / $214.68 / $1,037.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.52 / $125.04 / $162.75
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.68 / $215.30 / $297.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.95 / $258.05 / $443.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.52 / $97.65 / $150.47