go back

Oregon rates for HCPCS L5696

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.21 / $180.08 / $854.28
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 / $138.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.26 / $470.17 / $613.21
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.79 / $227.95 / $296.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.15 / $278.32 / $310.89
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.86 / $244.28 / $296.08
Pacific Source
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.07 / $281.29 / $296.08
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.16 / $246.71 / $310.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $259.27 / $325.70
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$246.69 / $492.38 / $1,038.79
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.64 / $325.70 / $325.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.31 / $355.31 / $473.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.85 / $110.79 / $211.37