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Kansas 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
$569.30 / $569.30 / $569.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.49 / $396.36 / $634.16
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.26 / $693.99 / $760.62
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$718.90 / $718.90 / $718.90
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 / $1,027.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$216.49 / $610.17 / $3,565.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.56 / $433.51 / $967.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.82 / $377.72 / $516.74