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Oklahoma 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
$117.21 / $117.21 / $117.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.21 / $133.96 / $133.96
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.21 / $239.21 / $239.21
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 / $159.21 / $159.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.51 / $164.08 / $1,295.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $160.69 / $276.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.06 / $129.72 / $183.19