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Colorado rates for HCPCS L5697

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Band

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.50 / $52.50 / $52.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.14 / $52.50 / $72.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.99 / $117.97 / $214.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.87 / $57.87 / $62.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.21 / $60.21 / $60.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $43.95 / $103.10
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.03 / $53.72 / $131.24
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.03 / $31.03 / $31.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.64 / $131.24 / $207.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.44 / $48.07 / $76.23