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Arizona rates for HCPCS L5652

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.09 / $235.48 / $389.47
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$392.46 / $392.46 / $392.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$137.38 / $496.30 / $897.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.45 / $457.94 / $618.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.50 / $338.50 / $338.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.11 / $247.11 / $606.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.53 / $349.64 / $2,725.44
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.95 / $261.06 / $402.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.95 / $261.06 / $393.25