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New Mexico rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.16 / $950.16 / $950.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$925.83 / $1,297.04 / $5,905.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,031.92 / $1,375.89 / $1,639.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$963.22 / $963.22 / $963.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.15 / $963.22 / $963.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,377.91 / $1,722.39 / $2,583.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$496.48 / $496.48 / $1,294.39
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.15 / $963.22 / $1,806.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.04 / $804.59 / $1,176.83