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Florida 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
$94.81 / $101.97 / $116.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.81 / $116.82 / $165.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.76 / $138.76 / $138.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $101.29 / $147.91
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.00 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.13 / $160.30 / $222.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.27 / $98.88 / $108.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.08 / $296.08 / $296.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.36 / $110.79 / $166.92
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.88 / $98.88 / $134.38