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Connecticut rates for HCPCS L5975

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.48 / $265.48 / $265.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.70 / $246.35 / $266.06
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$423.33 / $546.23 / $624.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.45 / $305.45 / $319.05
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 / $362.03
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.05 / $355.05 / $355.05
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.05 / $355.05 / $502.53
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.25 / $326.25 / $326.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.96 / $272.51 / $381.69