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Arizona rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,352.55 / $1,764.86 / $2,250.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,029.64 / $3,719.57 / $6,724.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,574.11 / $3,432.14 / $4,676.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $1,902.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,389.03 / $3,409.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.36 / $2,620.51 / $15,444.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.30 / $1,467.45 / $2,261.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.30 / $1,467.45 / $2,245.58