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New Jersey rates for HCPCS L5968

Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,573.49 / $1,573.49 / $1,573.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,573.49 / $1,912.12 / $2,783.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.80 / $2,448.80 / $4,281.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.62 / $1,787.62 / $3,749.27
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,911.71 / $3,939.23 / $5,609.12
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,075.46 / $4,281.77 / $4,281.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,930.67 / $2,252.44 / $3,930.88