go back

Oklahoma 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
$1,771.82 / $1,771.82 / $1,771.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,771.81 / $1,771.82 / $2,024.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,948.18 / $3,615.95 / $3,615.95
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,314.38 / $2,480.21 / $21,140.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.30 / $2,690.39 / $4,180.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,625.10 / $4,625.10 / $4,625.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,357.30 / $2,035.96 / $3,066.88