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Arizona rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.21 / $224.57 / $324.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.02 / $473.30 / $855.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.84 / $436.73 / $562.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $311.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $227.60 / $558.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.54 / $333.46 / $2,310.33
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.76 / $217.69 / $335.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.76 / $217.69 / $335.46