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Kansas 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
$178.24 / $178.24 / $178.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.52 / $124.09 / $198.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$183.25 / $199.94 / $212.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.46 / $198.46 / $198.46
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 / $138.76 / $342.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $191.04 / $1,184.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.86 / $135.72 / $302.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.68 / $251.68 / $296.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.84 / $118.26 / $170.72