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Kansas 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
$72.45 / $72.45 / $72.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.03 / $50.44 / $80.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.57 / $107.54 / $114.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.74 / $106.74 / $106.74
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 / $60.21 / $162.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31.03 / $77.66 / $510.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.04 / $55.17 / $123.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.04 / $48.07 / $74.06