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Georgia 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
$280.01 / $280.01 / $793.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.01 / $400.82 / $488.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.17 / $941.04 / $2,466.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.35 / $558.89 / $1,073.07
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$571.34 / $672.17 / $1,317.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$571.34 / $571.34 / $571.34
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 / $420.01 / $822.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$510.85 / $672.17 / $934.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.56 / $335.33 / $558.89