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Colorado rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.81 / $1,357.81 / $1,357.81
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$936.06 / $1,357.81 / $2,408.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,715.61 / $3,051.26 / $5,539.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,526.81 / $1,526.81 / $1,648.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,119.51 / $2,119.51 / $2,119.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.24 / $1,547.24 / $2,701.86
Denver HMP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$808.65 / $1,357.81 / $3,408.79
Denver HMP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.65 / $808.65 / $808.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,982.40 / $3,394.51 / $5,431.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,158.10 / $1,252.58 / $1,930.19