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Arizona rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,292.08 / $1,452.06 / $2,179.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.15 / $3,060.34 / $5,532.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,117.89 / $2,823.85 / $3,847.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $1,743.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $3,818.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.44 / $2,179.28 / $14,630.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.82 / $1,391.68 / $2,144.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.82 / $1,391.68 / $2,096.37