go back

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
$176.41 / $176.41 / $370.68
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.41 / $181.00 / $206.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.83 / $331.76 / $370.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.71 / $224.02 / $307.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.44 / $407.75 / $556.02
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.08 / $407.75 / $500.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $370.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $380.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.28 / $184.93 / $278.63