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Missouri rates for HCPCS L5790

Addition, exoskeletal system, above knee (AK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $602.56 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $501.19 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $524.81 / $831.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $912.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $588.84 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $588.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $707.95 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $446.68 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $707.95 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $446.68 / $660.69