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Missouri 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
$588.76 / $870.88 / $898.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.76 / $686.89 / $1,226.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.69 / $1,353.12 / $5,948.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.59 / $787.30 / $1,042.59
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.17 / $1,079.40 / $6,807.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.76 / $699.83 / $1,374.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,718.25 / $1,718.25 / $2,061.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.39 / $647.79 / $990.71