go back

New Jersey rates for HCPCS L5701

Replacement Socket Above Knee/Knee Disarticulation Including Attachment Plate Molded To Patient Model

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,526.42 / $1,526.42 / $1,526.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,526.42 / $1,878.12 / $3,034.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,550.04 / $2,550.04 / $4,153.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,861.53 / $1,861.53 / $3,637.11
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,794.69 / $3,821.39 / $5,441.32
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,953.54 / $4,153.68 / $4,153.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,625.10 / $5,441.30 / $6,529.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,872.91 / $2,168.12 / $4,153.68