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New Jersey rates for HCPCS L5631

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.39 / $258.39 / $258.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.50 / $287.66 / $336.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $703.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $240.56 / $611.25
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.38 / $646.90 / $921.13
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$686.67 / $703.15 / $703.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.45 / $350.79 / $645.53