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Arizona 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
Professional
Modifier
Low / Median / High Price
$9,854.33 / $10,091.35 / $16,789.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,749.14 / $20,768.78 / $37,549.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,372.86 / $19,163.82 / $26,110.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,513.81 / $14,513.81 / $14,513.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,595.08 / $10,595.08 / $26,010.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,455.32 / $14,631.97 / $104,478.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,037.45 / $9,999.21 / $15,408.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,037.45 / $9,999.21 / $15,062.41