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California rates for HCPCS L5728

Addition, exoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,715.30 / $1,715.30 / $10,986.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,302.17 / $1,715.30 / $10,986.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,302.56 / $5,366.18 / $12,087.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,457.79 / $1,715.30 / $2,706.06
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.00 / $4,508.29 / $8,050.51
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $5,052.53 / $11,769.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,781.06 / $2,050.41 / $2,050.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,496.80 / $1,496.80 / $3,373.13
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.26 / $1,350.31 / $4,188.76
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,284.78 / $2,665.57 / $5,788.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,906.77 / $15,093.28 / $18,087.81
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,918.90 / $19,372.95 / $23,832.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,097.15 / $6,097.15 / $6,097.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$919.83 / $3,053.24 / $3,807.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,496.80 / $1,496.80 / $3,286.82
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,187.38 / $7,187.38 / $7,187.38
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,125.26 / $1,912.94 / $3,046.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,341.17 / $1,673.42 / $3,807.96