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New Jersey rates for HCPCS L5677

Additions To Lower Extremity Below Knee Knee Joints Polycentric Pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$217.47 / $217.47 / $217.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.47 / $264.27 / $405.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.72 / $400.78 / $591.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.57 / $292.57 / $518.19
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.64 / $544.44 / $775.23
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$577.91 / $591.78 / $591.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.83 / $340.10 / $591.78