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Arkansas rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,787.51 / $9,787.51 / $9,787.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,439.81 / $9,787.51 / $9,787.51
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$219,999.78 / $539,999.46 / $949,999.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,201.62 / $20,119.79 / $22,355.32
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,095.98 / $17,095.98 / $17,610.77
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,095.98 / $17,095.98 / $17,095.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $14,087.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $13,757.12
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,222.91 / $8,784.99 / $12,305.69