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Kansas 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
$18,620.87 / $18,620.87 / $18,620.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.37 / $11,748.98 / $18,620.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,595.87 / $17,378.01 / $18,197.01
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,054.61 / $19,054.61 / $19,054.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $10,715.19 / $26,302.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $15,488.17 / $50,118.72
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $11,220.18 / $112,201.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $17,782.79 / $17,782.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,413.10 / $11,220.18 / $15,488.17