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Florida 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
$9,630.76 / $10,357.61 / $11,866.67
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,630.76 / $11,549.30 / $16,789.61
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 / $14,513.81
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,016.50 / $15,016.50 / $15,016.50
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,058.04 / $15,072.55 / $22,557.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,046.31 / $18,046.31 / $18,046.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,687.08 / $11,253.89 / $15,065.75
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,489.26 / $12,489.26 / $22,557.89