go back

Nebraska 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
$6,521.36 / $6,521.36 / $6,521.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,521.36 / $6,521.36 / $7,689.37
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,987.79 / $9,886.59 / $9,986.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $11,248.73 / $11,248.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,652.12 / $11,248.73 / $17,345.77
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,151.95 / $11,086.31 / $48,028.27
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,893.35 / $6,080.81 / $8,502.83
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,215.83 / $11,248.73 / $14,173.02
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,212.77 / $13,293.96 / $23,174.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,893.35 / $5,101.70 / $7,091.00