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Mississippi 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
$53.70 / $53.70 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $53.70 / $93.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $74.13 / $74.13
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 / $60.26
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 / $46.77 / $74.13