go back

Louisiana 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
$5,888.44 / $7,943.28 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $5,248.07 / $8,511.38
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $15,488.17 / $21,379.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $9,772.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $8,317.64 / $12,589.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $4,897.79 / $7,079.46