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New Mexico 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
$1,269.54 / $1,269.54 / $1,269.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,036.65 / $1,733.02 / $6,635.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.72 / $1,232.72 / $1,232.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.89 / $1,232.72 / $1,232.72
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,841.07 / $2,301.34 / $3,452.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.90 / $555.90 / $1,729.48
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.89 / $1,232.72 / $2,022.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.15 / $1,035.60 / $1,297.40