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Oklahoma rates for HCPCS L5210

Above knee (AK), short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,441.27 / $1,441.27 / $1,441.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,441.27 / $1,647.16 / $1,647.16
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,855.25 / $2,855.25 / $2,855.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.89 / $1,819.89 / $1,819.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.52 / $1,819.89 / $1,819.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.03 / $2,017.50 / $15,534.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.67 / $1,920.06 / $3,400.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,776.27 / $1,776.27 / $1,776.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.67 / $1,601.11 / $2,189.23