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Arizona rates for HCPCS L5677

Additions to lower extremity, below knee (BK), knee joints, polycentric, pair

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.74 / $355.07 / $440.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.15 / $748.34 / $1,352.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.88 / $690.50 / $940.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$400.78 / $400.78 / $400.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.57 / $292.57 / $772.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.60 / $527.22 / $3,128.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.83 / $295.24 / $454.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.83 / $295.24 / $444.73