go back

Louisiana rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,231.85 / $2,369.19 / $3,364.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,103.48 / $2,369.19 / $3,433.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,594.31 / $6,140.34 / $8,631.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,451.19 / $2,931.96 / $2,931.96
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,003.38 / $3,003.38 / $3,003.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,550.04 / $2,550.04 / $2,550.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,861.53 / $2,550.04 / $2,550.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,625.10 / $5,441.30 / $5,441.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.30 / $2,060.17 / $3,137.34