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New Mexico 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
Facility
Modifier
Low / Median / High Price
$2,327.98 / $2,327.98 / $2,327.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,988.34 / $3,177.90 / $12,735.70
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 / $2,482.86 / $2,482.86
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,376.04 / $4,220.06 / $6,330.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,066.25 / $1,066.25 / $3,171.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.49 / $2,482.86 / $4,945.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,272.54 / $2,182.50 / $2,363.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,527.05 / $1,651.61 / $2,545.08