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Nebraska rates for HCPCS L5855

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $316.23 / $316.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $316.23 / $2,137.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $478.63 / $478.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $537.03 / $831.76
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $537.03 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $245.47 / $489.78
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $691.83 / $1,230.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $549.54 / $549.54
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $707.95 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $281.84 / $426.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $245.47 / $371.54