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New Jersey rates for HCPCS L5100

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,117.85 / $1,117.85 / $1,117.85
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.85 / $1,323.77 / $2,016.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,712.20 / $1,743.07 / $3,041.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $3,818.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,779.01 / $2,798.55 / $3,984.89
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,970.61 / $3,041.90 / $3,041.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,371.61 / $1,626.02 / $2,792.62