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Oklahoma 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
$2,083.53 / $2,083.53 / $2,083.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,083.53 / $2,083.53 / $2,381.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,466.85 / $4,252.10 / $4,252.10
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 / $2,886.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.75 / $2,916.54 / $22,493.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.14 / $2,844.68 / $4,915.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,890.35 / $4,890.35 / $4,890.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.14 / $2,314.61 / $3,242.76