go back

New Jersey rates for HCPCS L5520

Preparatory, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$774.93 / $774.93 / $774.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$770.79 / $825.23 / $1,343.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.72 / $1,232.72 / $2,108.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.89 / $899.89 / $1,846.49
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.49 / $1,940.04 / $2,762.45
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,059.32 / $2,108.73 / $2,108.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.83 / $1,052.03 / $2,108.73