go back

Ohio 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
$5,021.12 / $5,021.12 / $10,359.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,893.88 / $5,021.12 / $6,910.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,655.96 / $11,311.58 / $29,307.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,151.95 / $5,635.06 / $13,368.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,712.44 / $10,283.25 / $13,882.39
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,720.32 / $9,305.06 / $22,018.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $6,652.12 / $12,115.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.05 / $4,856.05 / $8,498.08
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,652.12 / $6,652.12 / $6,652.12
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,856.05 / $6,652.12 / $6,652.12
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,776.00 / $3,817.01 / $5,004.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,420.14 / $5,130.20 / $7,091.00