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Oklahoma 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
$2,196.48 / $2,196.48 / $2,196.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,196.48 / $2,510.27 / $2,534.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,482.63 / $4,482.63 / $4,482.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.10 / $3,294.10 / $3,294.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,404.69 / $3,294.10 / $3,294.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,465.11 / $3,074.67 / $23,712.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.96 / $2,998.94 / $5,182.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,512.96 / $2,420.73 / $3,418.60