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Indiana rates for HCPCS L5698

Addition To Lower Extremity Above Knee Or Knee Disarticulation Silesian Bandage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.55 / $68.55 / $144.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.55 / $69.92 / $77.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.79 / $128.91 / $144.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.27 / $76.13 / $105.05
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.16 / $158.44 / $216.06
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.43 / $158.44 / $194.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.25 / $99.25 / $144.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.45 / $72.45 / $147.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.10 / $93.69 / $94.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.64 / $71.86 / $96.25