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Arizona rates for HCPCS L5971

All lower extremity prostheses, solid ankle cushion heel (SACH) foot, replacement only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.04 / $138.00 / $191.32
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.51 / $290.85 / $525.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.28 / $268.38 / $365.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.21 / $159.21 / $159.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.22 / $116.22 / $304.13
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.51 / $153.63 / $1,295.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.91 / $121.61 / $187.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.91 / $121.61 / $183.19