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Arizona rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,963.99 / $2,167.54 / $3,267.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,264.57 / $4,568.25 / $8,259.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,161.42 / $4,215.22 / $5,743.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,728.17 / $2,728.17 / $2,728.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.56 / $1,991.56 / $5,087.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.01 / $3,218.43 / $20,802.65
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.82 / $1,978.08 / $3,048.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.82 / $1,978.08 / $2,979.70