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Pennsylvania rates for HCPCS L5973

Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $35,481.34 / $35,481.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,912.51 / $10,471.29 / $17,782.79
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,417.38 / $20,417.38 / $20,417.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $12,882.50 / $20,892.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $9,332.54 / $12,882.50
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,054.61 / $27,542.29 / $39,810.72
Geisinger
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $20,892.96 / $20,892.96
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,589.25 / $14,791.08 / $20,892.96
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,803.84 / $13,803.84 / $13,803.84
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $9,120.11 / $35,481.34
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,912.51 / $10,715.19 / $18,197.01
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,113.11 / $33,113.11 / $33,113.11
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.60 / $29,512.09 / $40,738.03
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $14,791.08 / $19,498.45
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,791.08 / $14,791.08 / $19,952.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $25,703.96 / $30,902.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $11,220.18 / $18,620.87