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Indiana 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
$1,692.97 / $1,692.97 / $3,557.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,677.57 / $1,726.82 / $1,884.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,810.30 / $3,183.82 / $3,557.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,735.00 / $2,063.67 / $2,818.23
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,668.01 / $3,913.07 / $5,084.12
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,023.74 / $3,913.07 / $4,802.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,117.90 / $3,557.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $1,546.07 / $3,649.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.29 / $1,774.72 / $2,547.73