go back

Michigan rates for HCPCS L5700

Replacement, socket, below knee (BK), molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.69 / $2,114.69 / $2,114.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,699.84 / $2,114.69 / $2,114.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,604.62 / $11,166.56 / $20,337.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,517.78 / $3,702.93 / $4,998.96
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,235.30 / $2,247.57 / $2,406.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,962.34 / $2,962.34 / $2,962.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $2,400.00 / $2,400.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,400.00 / $2,400.00 / $4,293.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.69 / $2,675.92 / $2,675.92
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,973.72 / $2,675.92 / $3,888.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,246.93 / $2,740.17 / $3,151.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,366.51 / $1,770.23 / $2,600.71