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Missouri rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.91 / $316.39 / $326.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.91 / $245.10 / $445.64
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.15 / $351.15 / $351.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$468.20 / $491.61 / $2,161.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.23 / $272.08 / $378.79
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.77 / $293.77 / $293.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.45 / $214.45 / $313.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.91 / $377.34 / $2,270.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.86 / $250.27 / $421.98
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$473.13 / $473.13 / $473.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$564.00 / $564.00 / $676.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.86 / $233.58 / $331.56