go back

Ohio rates for HCPCS L5220

Above Knee Short Prosthesis No Knee Joint (Stubbies) With Articulated Ankle/Foot Dynamically Aligned Each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,874.10 / $1,874.10 / $4,193.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,623.36 / $1,874.10 / $2,473.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,604.02 / $4,221.97 / $10,938.73
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,922.93 / $1,988.34 / $4,989.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,494.80 / $3,838.15 / $5,181.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,494.80 / $3,454.34 / $8,218.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,482.86 / $2,482.86 / $4,343.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.49 / $1,812.49 / $3,171.85
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,482.86 / $2,482.86 / $2,482.86
Medical Mutual of Ohio
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
$1,628.19 / $2,238.76 / $2,935.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,492.75 / $2,485.42 / $3,070.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,276.54 / $1,914.82 / $2,545.08