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Arizona rates for HCPCS L5855

Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $223.87 / $741.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.82 / $302.00 / $630.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $501.19 / $954.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $239.88
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $331.13 / $1,995.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $186.21 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $281.84 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $186.21 / $275.42