go back

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
$40.74 / $40.74 / $40.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.74 / $57.54 / $107.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.83 / $131.83 / $138.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $57.54 / $77.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.70 / $60.26 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.65 / $43.65 / $85.11
Hometown Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $131.83 / $229.09
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $131.83 / $131.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36.31 / $63.10 / $72.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.67 / $69.18 / $117.49