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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
$9,549.93 / $10,471.29 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,549.93 / $11,481.54 / $16,982.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $10,715.19 / $14,454.40
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $13,803.84 / $22,908.68
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,197.01 / $18,197.01 / $18,197.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $15,135.61 / $22,387.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.37 / $11,220.18 / $15,135.61
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $22,908.68