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Arkansas rates for HCPCS L5858

Addition To Lower Extremity Prosthesis Endoskeletal Knee Shin System Microprocessor Control Feature Stance Phase Only Includes Electronic Sensor(S) Any Type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,536.98 / $12,536.98 / $12,536.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,529.76 / $12,536.98 / $12,536.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,471.99 / $25,771.75 / $28,635.28
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,898.50 / $21,898.50 / $22,557.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21,898.50 / $21,898.50 / $21,898.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,513.81 / $14,513.81 / $18,044.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,595.08 / $14,513.81 / $17,621.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,666.14 / $11,252.84 / $15,071.15