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New Jersey rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $724.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,000.00 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,318.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,137.96 / $2,951.21
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,995.26 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,047.13 / $1,659.59