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Arizona rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,121.52 / $2,172.55 / $3,614.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.72 / $4,471.26 / $8,083.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,094.30 / $4,125.74 / $5,621.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,886.72 / $2,886.72 / $2,886.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,107.31 / $5,599.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.75 / $3,150.08 / $22,493.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,945.66 / $2,152.71 / $3,317.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,945.66 / $2,152.71 / $3,242.76