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North Carolina 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
$1,278.88 / $1,278.88 / $2,595.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.89 / $1,278.88 / $1,278.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,565.33 / $2,548.78 / $3,138.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.40 / $1,288.69 / $1,288.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $1,062.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $850.30 / $1,494.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.05 / $1,278.88 / $1,934.99
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$966.00 / $966.00 / $1,206.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.40 / $1,546.40 / $2,377.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.91 / $857.21 / $1,210.34
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,616.04 / $6,807.72 / $6,807.72
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,505.34 / $8,505.34 / $9,665.18