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Ohio rates for HCPCS L5100

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,608.25 / $1,608.25 / $3,579.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,394.78 / $1,608.25 / $2,136.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,092.77 / $3,623.06 / $9,387.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,650.15 / $1,696.36 / $4,281.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,166.21 / $3,293.69 / $4,446.47
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,140.90 / $2,964.32 / $7,052.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $3,595.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $2,738.64
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $1,743.07
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,743.07 / $1,743.08
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,780.67 / $2,448.42 / $3,209.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.46 / $1,643.18 / $2,144.53