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Arizona rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.70 / $840.65 / $1,393.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$490.44 / $1,771.71 / $3,203.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,226.10 / $1,634.81 / $2,227.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,167.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $852.13 / $2,803.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$601.66 / $1,301.89 / $9,793.70
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.33 / $931.98 / $1,436.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.49 / $931.98 / $1,403.89