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Nebraska rates for HCPCS L5974

All Lower Extremity Prostheses Foot Single Axis Ankle/Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.26 / $194.26 / $194.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.26 / $194.26 / $229.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.73 / $294.50 / $297.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $335.08 / $335.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.77 / $335.08 / $516.69
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.61 / $333.43 / $1,528.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.98 / $186.05 / $253.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$334.10 / $335.08 / $424.88
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.61 / $396.01 / $690.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.98 / $166.36 / $215.02