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Arizona rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.92 / $237.31 / $392.50
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.52 / $395.52 / $395.52
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.44 / $500.14 / $904.24
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$374.97 / $461.50 / $594.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $329.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $240.56 / $611.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.85 / $352.37 / $2,777.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.79 / $263.08 / $405.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.25 / $263.08 / $396.31