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New Jersey rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.44 / $155.44 / $155.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.44 / $188.90 / $298.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.97 / $293.77 / $423.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.45 / $214.45 / $370.40
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.45 / $389.16 / $554.13
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.09 / $423.00 / $423.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.40 / $564.00 / $676.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.73 / $241.57 / $423.00