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Kansas 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
$7,689.37 / $7,689.37 / $7,689.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,970.74 / $5,353.36 / $8,565.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,546.18 / $8,233.25 / $8,732.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,172.17 / $8,172.17 / $8,172.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $6,652.12 / $6,652.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.05 / $6,652.12 / $14,901.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,970.74 / $7,920.05 / $48,028.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,067.77 / $5,466.25 / $13,064.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,401.13 / $5,101.70 / $7,091.00