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Kentucky 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
$244.33 / $319.89 / $332.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.61 / $337.63 / $378.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.43 / $672.17 / $706.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.38 / $403.70 / $409.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$504.13 / $947.76 / $1,135.11
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.55 / $840.21 / $1,109.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $420.01 / $876.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $420.01 / $3,672.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.27 / $428.39 / $535.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.56 / $335.33 / $516.74