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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
$10,715.19 / $10,715.19 / $11,220.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,549.93 / $11,220.18 / $18,620.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $22,908.68 / $23,988.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,471.29 / $12,022.64 / $12,589.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,982.44 / $30,199.52 / $39,810.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,387.21 / $28,183.83 / $36,307.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $35,481.34 / $35,481.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $18,197.01 / $107,151.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,220.18 / $14,125.38 / $18,197.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $13,182.57 / $15,848.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,585.78 / $11,220.18 / $15,488.17