go back

North Carolina 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
$7,695.18 / $7,695.18 / $15,617.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,625.16 / $7,695.18 / $7,695.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,289.27 / $9,947.12 / $18,887.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,893.20 / $7,754.21 / $7,754.21
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 / $11,921.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,970.74 / $7,695.18 / $11,654.67
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,253.61 / $7,253.61 / $7,253.61
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,198.00 / $12,198.00 / $18,754.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,962.89 / $5,157.99 / $7,479.09
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,275.86 / $48,028.27 / $48,028.27
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51,669.39 / $51,669.39 / $76,237.28