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Indiana rates for HCPCS L5830

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,141.51 / $1,141.51 / $2,398.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,127.24 / $1,171.19 / $1,266.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,894.89 / $2,146.75 / $2,398.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,170.00 / $1,376.42 / $1,886.27
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,798.95 / $2,638.46 / $3,416.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,038.81 / $2,638.46 / $3,238.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,654.54 / $1,654.54 / $2,398.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.81 / $1,654.54 / $2,460.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.48 / $1,196.63 / $1,750.88