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Nevada 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
$41.62 / $41.62 / $106.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.62 / $54.05 / $106.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.47 / $128.47 / $128.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.87 / $57.87 / $128.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.21 / $60.21 / $94.57
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $60.21 / $84.90
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.44 / $106.82 / $185.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.64 / $48.07 / $80.11