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Arizona rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.61 / $72.72 / $100.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42.43 / $153.29 / $277.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.07 / $141.43 / $192.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.19 / $89.19 / $89.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.11 / $65.11 / $159.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.04 / $107.98 / $645.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.65 / $60.47 / $93.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.65 / $60.47 / $91.08