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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
$1,230.27 / $1,621.81 / $6,760.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $1,949.84 / $4,073.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,235.94 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,737.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $2,187.76 / $14,791.08
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,380.38 / $16,982.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $2,137.96 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,380.38 / $2,089.30