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Missouri 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
$2,195.96 / $3,248.21 / $3,352.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,195.96 / $2,516.21 / $4,574.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,604.91 / $3,604.91 / $3,604.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,806.54 / $5,046.87 / $22,186.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,453.54 / $2,902.12 / $3,953.56
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 / $2,107.31 / $3,077.39
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,195.96 / $3,873.69 / $22,493.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,793.93 / $2,569.28 / $4,267.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,753.36 / $5,753.36 / $6,904.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,793.93 / $2,397.94 / $3,403.76