go back

Illinois rates for HCPCS L5857

Addition To Lower Proximity Prosthesis Endoskeletal Knee-Shin System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,089.64 / $5,089.64 / $5,089.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,482.18 / $5,089.64 / $8,437.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,287.52 / $20,788.32 / $88,479.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $6,652.12 / $11,248.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.05 / $6,652.12 / $11,921.25
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,740.76 / $10,283.25 / $12,663.00
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,368.23 / $13,368.23 / $13,368.23
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,266.45 / $8,952.08 / $9,399.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,834.71 / $5,130.20 / $9,084.20