go back

Louisiana 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
$54.95 / $74.13 / $77.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $53.70 / $83.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.18 / $144.54 / $199.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.18 / $69.18 / $69.18
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.26 / $60.26 / $60.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $91.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.10 / $77.62 / $131.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $47.86 / $72.44