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Illinois rates for HCPCS L5782

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,520.36 / $2,520.36 / $2,520.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,219.53 / $2,520.36 / $4,177.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,084.93 / $10,294.62 / $43,814.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,870.09 / $3,870.09 / $3,870.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.10 / $3,294.10 / $5,573.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,404.69 / $3,294.10 / $5,903.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,542.56 / $5,573.56 / $7,063.93
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,619.89 / $6,619.89 / $6,619.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,103.12 / $4,433.03 / $4,654.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.16 / $2,540.44 / $4,852.26