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Kansas 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
$208.93 / $208.93 / $208.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $138.04 / $218.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$141.25 / $147.91 / $158.49
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $173.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $158.49 / $158.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $117.49 / $302.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $177.83 / $562.34
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $125.89 / $1,479.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $199.53 / $204.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $125.89 / $186.21