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Florida 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
$40.74 / $43.65 / $50.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $52.48 / $75.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $72.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $60.26
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33.11 / $33.11 / $47.86
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.88 / $58.88 / $97.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $52.48 / $64.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.65 / $72.44 / $95.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $47.86 / $72.44
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $52.48 / $97.72