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Arkansas rates for HCPCS L5857

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $5,754.40 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $4,897.79 / $7,943.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,912.51 / $8,912.51 / $11,748.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $8,511.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $4,897.79 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $10,715.19 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $4,897.79 / $7,079.46