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Missouri rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.16 / $205.86 / $212.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.43 / $159.47 / $289.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$304.62 / $319.85 / $1,406.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.65 / $170.68 / $246.45
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $174.77 / $174.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $127.58 / $186.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$139.16 / $245.49 / $1,528.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.28 / $164.63 / $290.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.98 / $151.97 / $215.72