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Arkansas rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,839.86 / $1,839.86 / $1,839.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,199.26 / $1,839.86 / $1,839.86
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,648.13 / $2,648.13 / $2,648.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,857.60 / $3,782.12 / $4,202.35
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,755.79 / $2,755.79 / $3,301.52
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,755.79 / $2,755.79 / $2,755.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $2,648.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,721.98 / $2,586.06
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,045.35 / $3,045.35 / $3,045.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,123.22 / $3,123.22 / $3,674.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.56 / $1,651.40 / $2,118.58