go back

Arizona rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.74 / $730.09 / $1,278.88
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.45 / $1,161.29 / $2,099.56
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.65 / $1,071.54 / $1,459.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $908.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $1,494.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.05 / $894.98 / $6,807.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.08 / $642.91 / $990.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.08 / $642.91 / $968.46