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Arizona rates for HCPCS L5782

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system, heavy-duty

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,236.55 / $2,290.36 / $3,810.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,304.83 / $4,713.71 / $8,522.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,262.09 / $4,349.45 / $5,926.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.10 / $3,294.10 / $3,294.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,404.69 / $2,404.69 / $5,903.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,465.11 / $3,320.90 / $23,712.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.16 / $2,269.44 / $3,497.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.16 / $2,269.44 / $3,418.60