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Arizona rates for HCPCS L5976

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.70 / $403.30 / $500.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$235.30 / $850.01 / $1,536.78
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.23 / $784.31 / $1,068.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $420.01 / $420.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $306.61 / $822.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.49 / $598.83 / $3,565.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.08 / $335.33 / $516.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.08 / $335.33 / $505.14