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Arizona rates for HCPCS L5637

Addition To Lower Extremity Below Knee Total Contact

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.11 / $207.23 / $258.07
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.38 / $345.38 / $414.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.90 / $436.77 / $789.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.44 / $403.00 / $518.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.98 / $232.98 / $232.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.08 / $170.08 / $535.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$111.68 / $307.69 / $1,951.09
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$156.34 / $172.98 / $266.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.94 / $172.98 / $260.57