go back

Wisconsin rates for HCPCS L5910

Addition Endoskeletal System Below Knee Alignable System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.29 / $219.29 / $219.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.09 / $219.29 / $365.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.70 / $478.17 / $791.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$391.23 / $404.27 / $534.67
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.72 / $930.26 / $930.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.20 / $898.69 / $1,813.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.28 / $630.00 / $822.70
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.00 / $328.94 / $499.91
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.90 / $434.70 / $521.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219.29 / $434.70 / $2,291.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.12 / $290.45 / $473.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $226.93
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.00 / $335.51 / $499.91
Prevea360
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.90 / $434.70 / $521.64
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.70 / $669.00 / $1,300.80
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.20 / $849.02 / $2,291.37
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$205.28 / $281.20 / $2,886.41
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.70 / $434.70 / $434.70
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$347.10 / $434.70 / $434.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.72 / $260.82 / $420.85