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Oklahoma 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
$1,892.27 / $1,892.27 / $1,892.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,892.27 / $2,162.60 / $2,183.05
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.26 / $4,410.26 / $4,410.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,148.62 / $3,861.78 / $3,861.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.80 / $2,448.80 / $2,448.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.62 / $2,448.80 / $2,448.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,262.19 / $2,648.82 / $20,504.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.42 / $2,583.58 / $4,361.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.42 / $2,102.14 / $2,945.12