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Kentucky 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
$10,735.48 / $11,164.89 / $11,164.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.87 / $10,955.24 / $11,958.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,042.29 / $22,557.89 / $23,708.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,550.78 / $12,037.84 / $12,489.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,918.41 / $31,410.85 / $36,132.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21,430.00 / $28,045.40 / $37,220.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,513.81 / $14,513.81 / $26,435.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,595.08 / $14,513.81 / $107,604.38
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,123.54 / $13,565.30 / $16,956.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,502.59 / $11,253.89 / $15,301.50