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Arizona rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,480.99 / $1,986.34 / $2,868.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,059.38 / $3,827.02 / $6,919.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,648.45 / $3,531.27 / $4,811.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,482.86 / $2,482.86 / $2,482.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.49 / $1,812.49 / $4,449.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,066.25 / $2,949.37 / $17,674.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.75 / $1,651.61 / $2,545.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$26.38 / $2,307.14 / $2,545.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.75 / $1,651.61 / $2,487.91