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Michigan rates for HCPCS L5974

All Lower Extremity Prostheses Foot Single Axis Ankle/Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.72 / $159.72 / $159.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.57 / $159.72 / $177.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$423.33 / $843.43 / $1,536.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.70 / $279.69 / $377.58
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.80 / $181.80 / $231.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.75 / $223.75 / $223.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $174.77 / $174.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.77 / $174.77 / $324.38
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.72 / $202.12 / $202.12
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$159.72 / $202.12 / $313.48
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.71 / $206.97 / $238.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.28 / $139.54 / $215.02