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Arizona rates for HCPCS L5679

Addition To Lower Extremity Below Knee/Above Kneecustom Fabricated Fromexisting Mold Or Prefabric Ated Socket Insert Silicone Gel Elastomeric Or Equal Not For Use With Locking Mechanism

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.14 / $352.67 / $529.30
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.79 / $587.79 / $587.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$205.75 / $743.28 / $1,343.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$557.25 / $685.85 / $900.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.05 / $440.05 / $440.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.24 / $321.24 / $916.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$215.25 / $523.66 / $3,490.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.35 / $333.42 / $513.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.35 / $333.42 / $513.79