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Indiana rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$644.03 / $644.03 / $1,353.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$556.34 / $644.03 / $669.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,069.08 / $1,211.18 / $1,353.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.17 / $682.97 / $942.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$955.45 / $1,420.93 / $1,894.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,150.28 / $1,488.60 / $1,826.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $702.38 / $1,353.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $702.38 / $1,388.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$373.85 / $675.13 / $894.95