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Arkansas rates for HCPCS L5795

Addition Exoskeletal System Hip Disarticulation Ultra-Light Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$955.04 / $955.04 / $955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.80 / $955.04 / $955.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,483.33 / $1,963.23 / $2,181.37
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.69 / $1,288.69 / $1,718.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.69 / $1,288.69 / $1,288.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $1,374.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $1,291.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,460.51 / $1,460.51 / $1,718.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.61 / $849.57 / $1,030.95