go back

Arizona rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,785.90 / $3,736.51 / $4,992.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,992.81 / $7,199.02 / $13,015.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,982.01 / $6,642.68 / $9,050.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,366.38 / $4,366.38 / $4,366.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,187.46 / $3,187.46 / $7,825.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,005.72 / $5,548.07 / $33,390.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,808.01 / $3,106.84 / $4,787.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,808.01 / $3,106.84 / $4,680.02