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Georgia rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,023.07 / $2,023.07 / $5,730.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,023.07 / $2,436.69 / $3,236.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,593.77 / $3,593.77 / $3,593.77
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,856.45 / $6,799.03 / $17,823.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,589.13 / $4,038.05 / $7,753.06
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,007.31 / $4,127.97 / $8,984.43
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,127.97 / $4,127.97 / $4,127.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,886.72 / $2,886.72 / $2,886.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,886.72 / $5,599.88
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,690.90 / $4,856.45 / $6,747.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,615.22 / $2,422.83 / $3,997.24