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Arkansas rates for HCPCS L5697

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.48 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.81 / $52.48 / $85.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $83.18 / $109.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $79.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $43.65 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $112.20 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $47.86 / $74.13