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Ohio 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
$1,736.98 / $1,736.98 / $4,321.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,692.97 / $1,736.98 / $2,611.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.34 / $3,913.07 / $10,138.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,735.00 / $2,035.69 / $4,624.54
Aultcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,023.74 / $3,023.74 / $3,023.74
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,631.49 / $3,557.34 / $4,802.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,312.27 / $3,201.61 / $7,616.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,117.90 / $4,362.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $1,546.07 / $2,957.86
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,117.90 / $2,117.90 / $2,117.90
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,546.07 / $2,117.90 / $2,117.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.20 / $2,644.41 / $3,466.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,183.14 / $1,774.72 / $2,605.67