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Indiana rates for HCPCS L5321

Above knee (AK), molded socket, open end, SACH foot, endoskeletal system, single axis knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,041.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $2,137.96 / $3,388.44
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $3,388.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $4,365.16 / $5,495.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,884.03 / $4,786.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $6,025.60 / $7,244.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,454.71 / $3,388.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $3,090.30 / $3,467.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,137.96 / $3,019.95