go back

New Mexico 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
$1,129.75 / $1,129.75 / $1,129.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.98 / $1,542.20 / $5,736.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $1,317.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,317.79 / $1,317.79
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,638.35 / $2,047.94 / $3,071.91
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.11 / $586.11 / $1,539.04
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,317.79 / $2,330.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.41 / $907.89 / $1,389.30