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New Mexico 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
$1,826.05 / $1,826.05 / $1,826.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,655.14 / $2,492.69 / $10,556.20
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,983.19 / $2,644.25 / $3,150.66
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
$1,257.05 / $1,721.98 / $1,721.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,879.09 / $4,848.87 / $7,273.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$887.57 / $887.57 / $2,487.62
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,721.98 / $3,879.10
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
$1,271.15 / $1,374.83 / $2,103.87