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Indiana rates for HCPCS L5940

Addition, endoskeletal system, below knee (BK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.52 / $286.52 / $602.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.52 / $293.97 / $334.80
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.44 / $421.44 / $451.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$475.62 / $538.83 / $602.04
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$293.79 / $365.89 / $496.69
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.54 / $662.26 / $903.08
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$511.74 / $662.26 / $812.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $602.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.88 / $382.03 / $617.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.24 / $300.36 / $455.72