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Arizona rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,847.52 / $2,448.59 / $3,460.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,080.98 / $4,080.98 / $4,080.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.54 / $5,160.59 / $9,330.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,571.34 / $4,761.79 / $6,428.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,550.04 / $2,550.04 / $2,550.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,861.53 / $1,861.53 / $5,325.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,314.38 / $3,635.72 / $21,140.73
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.13 / $2,035.96 / $3,137.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.13 / $2,035.96 / $3,066.88