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Missouri 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
$364.81 / $539.61 / $556.90
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.98 / $418.01 / $760.02
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.99 / $534.99 / $598.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$798.49 / $838.41 / $3,685.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$361.59 / $365.89 / $646.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $382.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.88 / $278.88 / $447.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.66 / $643.53 / $3,201.26
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.57 / $398.36 / $642.19
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$738.52 / $738.52 / $738.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.57 / $398.36 / $565.45