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New Jersey rates for HCPCS L5974

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.78 / $102.78 / $102.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.78 / $156.25 / $194.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$164.00 / $174.77 / $279.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $127.58 / $244.91
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.52 / $257.31 / $366.39
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$273.14 / $279.69 / $279.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.01 / $141.06 / $279.69