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Louisiana 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
$12,190.57 / $12,940.76 / $18,379.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,875.32 / $12,940.76 / $18,754.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,632.45 / $33,539.08 / $47,143.76
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,388.62 / $16,014.61 / $16,014.61
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
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 / $14,513.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,666.14 / $11,696.06 / $15,942.11