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Michigan rates for HCPCS L5780

Addition Exoskeletal Knee-Shin System Single Axis Pneumatic/Hydra Pneumatic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$914.90 / $914.90 / $914.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.81 / $914.90 / $914.90
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,424.78 / $4,831.08 / $8,798.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,521.93 / $1,602.03 / $2,162.73
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$893.21 / $928.85 / $1,041.32
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.61 / $1,281.61 / $1,281.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.33 / $1,036.33 / $1,036.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,036.33 / $1,036.33 / $1,857.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$914.90 / $1,157.71 / $1,157.71
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$893.01 / $1,157.71 / $1,743.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$972.11 / $1,185.50 / $1,363.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.29 / $765.88 / $1,087.29