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Arizona rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,280.28 / $2,899.66 / $3,793.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,546.49 / $5,586.69 / $10,100.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,866.21 / $5,154.95 / $7,023.62
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,578.08 / $3,578.08 / $3,578.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.00 / $2,612.00 / $6,412.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,556.51 / $4,305.50 / $25,854.57
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,179.12 / $2,411.02 / $3,715.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,179.12 / $2,411.02 / $3,631.86