go back

Arkansas rates for HCPCS L5696

Addition to lower extremity, above knee (AK) or knee disarticulation, pelvic joint

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$148.07 / $148.07 / $148.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.11 / $148.07 / $148.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.99 / $304.39 / $338.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$222.07 / $222.07 / $249.63
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$249.63 / $249.63 / $249.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.76 / $138.76 / $213.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $138.76 / $208.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.68 / $251.68 / $296.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.86 / $132.91 / $170.72