go back

Florida 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
$1,154.41 / $1,241.53 / $1,422.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,154.41 / $1,338.27 / $2,012.52
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 / $2,119.51
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99,999.99 / $99,999.99 / $99,999.99
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.22 / $2,032.03 / $2,703.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,163.16 / $2,163.16 / $2,163.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,161.16 / $1,348.97 / $1,886.84
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,526.81 / $1,526.81 / $2,703.95