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New Jersey rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.38 / $1,720.38 / $1,720.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,720.38 / $1,883.80 / $3,137.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,220.20 / $3,249.00 / $4,681.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $2,371.77 / $4,099.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,276.87 / $4,306.96 / $6,132.74
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,571.76 / $4,681.47 / $4,681.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,102.75 / $2,673.55 / $4,681.47