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Arizona rates for HCPCS L5505

Initial, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$953.74 / $1,252.56 / $1,586.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$668.03 / $2,413.27 / $4,363.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,670.08 / $2,226.77 / $3,033.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,620.00 / $1,620.00 / $1,620.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.59 / $1,182.59 / $2,903.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.36 / $1,859.84 / $11,250.63
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.31 / $1,041.48 / $1,604.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.31 / $1,041.48 / $1,568.85