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Arizona rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.80 / $251.74 / $418.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.41 / $518.05 / $936.63
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.51 / $478.02 / $651.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $362.03 / $362.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.27 / $264.27 / $648.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.02 / $364.98 / $2,615.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.44 / $249.43 / $384.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$225.44 / $249.43 / $375.73