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Louisiana rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,703.36 / $2,869.72 / $4,075.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,408.08 / $2,869.72 / $4,159.02
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,353.66 / $7,437.58 / $10,454.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,969.04 / $3,551.37 / $3,551.37
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,853.06 / $2,853.06 / $2,853.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,853.06 / $2,853.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,518.59 / $2,543.71 / $3,510.16