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Georgia rates for HCPCS L5971

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.55 / $101.55 / $287.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.55 / $146.22 / $191.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$243.76 / $341.26 / $894.60
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.50 / $202.68 / $389.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.20 / $223.97 / $450.96
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.20 / $207.20 / $207.20
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
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.26 / $243.76 / $544.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$95.22 / $121.61 / $200.63