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Connecticut 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
$62.44 / $62.44 / $62.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.93 / $45.56 / $62.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.56 / $128.47 / $146.97
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.87 / $57.87 / $61.49
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 / $60.21
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.51 / $83.51 / $83.51
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.63 / $83.51 / $105.99
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.21 / $61.21 / $61.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.91 / $64.09 / $79.64