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Michigan 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
$343.82 / $343.82 / $981.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.62 / $343.82 / $343.82
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.54 / $602.04 / $602.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$911.24 / $1,815.54 / $3,306.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.95 / $602.04 / $812.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$391.33 / $391.33 / $391.33
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.64 / $481.64 / $481.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $382.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.03 / $382.03 / $697.88
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$343.82 / $435.07 / $981.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.82 / $435.07 / $677.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.32 / $445.52 / $512.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.30 / $300.36 / $462.84