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Rhode Island 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
$238.66 / $300.27 / $323.97
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.28 / $1,043.08 / $1,234.89
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.78 / $356.78 / $493.96
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 / $362.03 / $362.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.30 / $332.57 / $454.18