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Indiana rates for HCPCS L5822

Addition, endoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,006.29 / $1,006.29 / $2,114.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,006.29 / $1,026.41 / $1,127.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,670.42 / $1,892.44 / $2,114.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.34 / $1,242.91 / $1,699.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,585.85 / $2,325.91 / $3,065.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,797.29 / $2,325.91 / $2,854.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.82 / $1,367.82 / $2,114.46
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.51 / $1,367.82 / $2,165.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.63 / $1,529.51 / $1,536.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.78 / $1,054.88 / $1,547.09