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New Jersey 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
Facility
Modifier
Low / Median / High Price
$767.17 / $767.17 / $767.17
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$767.17 / $932.26 / $1,507.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,210.33 / $1,620.00 / $2,087.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.59 / $1,182.59 / $1,827.97
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,907.17 / $1,920.59 / $2,734.76
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,987.01 / $2,087.60 / $2,087.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,365.94 / $2,783.46 / $3,340.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$941.31 / $1,041.48 / $2,087.60