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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
$16,787.75 / $16,787.75 / $16,787.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,455.32 / $11,687.68 / $18,700.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,018.08 / $17,476.50 / $18,537.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,346.84 / $17,346.84 / $17,346.84
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 / $14,513.81 / $32,512.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,455.32 / $17,436.84 / $104,478.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,666.14 / $11,934.15 / $28,522.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,425.50 / $11,138.25 / $15,408.48