go back

New Jersey rates for HCPCS L5301

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,012.72 / $1,012.72 / $1,012.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,012.72 / $1,230.67 / $1,991.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $2,755.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,257.05 / $2,413.07
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,517.61 / $2,535.33 / $3,610.08
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,623.00 / $2,755.79 / $2,755.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,123.22 / $3,674.38 / $4,409.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.59 / $1,430.21 / $2,529.94