go back

Arkansas rates for HCPCS L5828

Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,883.90 / $1,883.90 / $1,883.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,451.57 / $1,883.90 / $1,883.90
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,711.53 / $2,711.53 / $2,711.53
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
$2,926.01 / $3,872.66 / $4,302.96
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,389.41 / $3,389.41 / $3,508.65
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,508.65 / $3,508.65 / $3,508.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,117.90 / $2,711.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $1,546.07 / $2,547.16
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,118.26 / $3,118.26 / $3,118.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.29 / $1,690.94 / $2,605.67