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Indiana rates for HCPCS L5855

Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $177.83 / $177.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $194.98 / $323.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$223.87 / $380.19 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $389.05
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $512.86 / $616.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $295.12 / $295.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $186.21 / $281.84