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Mississippi 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
$12,589.25 / $12,589.25 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.37 / $12,022.64 / $19,054.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,620.87 / $18,620.87 / $18,620.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,620.87 / $18,620.87 / $18,620.87
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 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,182.57 / $18,197.01 / $27,542.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $10,715.19 / $15,488.17