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Connecticut rates for HCPCS L5795

Addition Exoskeletal System Hip Disarticulation Ultra-Light Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$835.12 / $835.12 / $835.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.80 / $752.28 / $835.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,331.64 / $1,718.25 / $1,965.85
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$787.30 / $787.30 / $822.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $908.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $662.92
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,116.85 / $1,116.85 / $1,116.85
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$837.65 / $1,116.85 / $1,417.56
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.65 / $1,091.65 / $1,091.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.17 / $857.21 / $1,065.21