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South Carolina 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
$7,878.23 / $7,878.23 / $7,878.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,439.81 / $7,878.23 / $13,107.52
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,610.77 / $17,610.77 / $21,192.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $10,833.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $9,812.54
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,878.23 / $13,107.52 / $28,495.74
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,646.99 / $13,646.99 / $13,646.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,915.78 / $8,785.82 / $12,169.09