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Michigan rates for HCPCS L5301

Below Knee, Molded Socket, Shin, Sach Foot, Endoskeletal System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,847.09 / $1,847.09 / $4,574.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,430.99 / $1,847.09 / $1,847.09
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,895.34 / $9,753.42 / $17,764.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,072.60 / $3,234.32 / $4,366.33
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,791.26 / $2,102.31 / $2,145.98
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,587.46 / $2,587.46 / $2,587.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $1,721.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $3,749.63
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,337.28 / $3,646.89 / $4,574.22
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,723.95 / $2,337.28 / $3,396.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,962.58 / $2,393.40 / $2,752.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,123.22 / $3,674.38 / $3,674.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,145.70 / $1,546.21 / $2,314.88