go back

Arizona rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.12 / $351.56 / $447.63
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$585.94 / $585.94 / $585.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.10 / $740.94 / $1,339.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$555.50 / $683.69 / $880.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $379.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $679.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $522.01 / $3,128.86
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.20 / $292.32 / $450.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.20 / $292.32 / $440.33