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Arkansas rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $380.19 / $588.84
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $660.69
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218,776.16 / $524,807.46 / $954,992.59
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $831.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $309.03 / $416.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $776.25 / $912.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $346.74 / $512.86