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New Jersey rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,008.95 / $1,008.95 / $1,008.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.95 / $1,146.77 / $1,838.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,617.40 / $1,769.38 / $2,745.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,291.65 / $2,404.12
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,508.28 / $2,525.92 / $3,596.71
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,681.23 / $2,745.58 / $2,745.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,209.93 / $1,393.81 / $2,745.58