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New Mexico rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,218.10 / $16,218.10 / $16,218.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $15,488.17 / $24,547.09
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21,877.62 / $26,302.68 / $26,915.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,378.01 / $23,442.29 / $27,542.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,218.10 / $16,218.10 / $16,218.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $42,657.95
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,442.29 / $28,840.32 / $43,651.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $21,379.62 / $28,840.32
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,748.98 / $11,748.98 / $33,884.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $19,498.45 / $35,481.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,022.64 / $14,125.38 / $19,498.45