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Missouri 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
$630.77 / $933.01 / $962.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.77 / $722.76 / $1,314.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.63 / $1,449.66 / $6,372.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.73 / $682.97 / $1,116.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $702.38 / $702.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $512.74 / $748.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$624.77 / $1,112.66 / $5,917.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.32 / $737.98 / $1,195.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.32 / $688.78 / $922.48