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New York rates for HCPCS L5671

Addition to lower extremity, below knee (BK)/above knee (AK) suspension locking mechanism (shuttle, lanyard, or equal), excludes socket insert

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $478.63 / $933.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $323.59 / $602.56
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $512.86 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $426.58 / $1,071.52
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $501.19 / $501.19
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $501.19 / $501.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $1,122.02 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $602.56
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $1,000.00 / $2,344.23
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $645.65 / $1,174.90
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $478.63
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $380.19 / $457.09
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$602.56 / $602.56 / $1,148.15
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $588.84 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $691.83 / $812.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $323.59 / $501.19
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $398.11 / $478.63
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $380.19 / $457.09