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Arkansas rates for HCPCS L5857

Addition To Lower Proximity Prosthesis Endoskeletal Knee-Shin System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,746.10 / $5,746.10 / $5,746.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,423.59 / $5,746.10 / $5,746.10
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,924.62 / $11,812.01 / $13,124.46
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,036.81 / $10,036.81 / $10,338.95
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,036.81 / $10,036.81 / $10,036.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $6,652.12 / $8,270.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.05 / $6,652.12 / $8,076.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,067.77 / $5,157.53 / $7,041.76