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Mississippi 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
$1,515.31 / $1,515.31 / $2,367.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.12 / $2,272.96 / $2,606.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,095.35 / $2,095.35 / $2,095.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,095.35 / $2,095.35 / $2,095.35
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
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.06 / $1,348.97 / $2,135.87