go back

Nebraska 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
$11,115.27 / $11,115.27 / $11,115.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,115.27 / $11,115.27 / $13,106.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,319.17 / $16,851.09 / $17,021.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $19,172.79 / $19,172.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,812.54 / $19,172.79 / $29,564.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,115.27 / $19,078.45 / $81,836.25
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,635.98 / $10,952.18 / $13,641.82
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,116.70 / $19,172.79 / $24,157.06
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,359.50 / $22,978.76 / $39,499.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,635.98 / $8,695.54 / $12,169.09