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North Carolina rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.08 / $307.08 / $623.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.00 / $307.08 / $307.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$330.78 / $396.94 / $753.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.17 / $309.44 / $309.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $255.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $429.75
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.39 / $307.08 / $460.05
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.00 / $232.00 / $290.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.90 / $442.90 / $683.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.13 / $205.83 / $292.80
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$721.58 / $2,347.59 / $2,347.59
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,447.21 / $2,447.21 / $2,780.10