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New Jersey 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
$311.69 / $311.69 / $311.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.17 / $331.92 / $482.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $420.01 / $848.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $306.61 / $742.67
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.86 / $780.30 / $1,111.08
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$807.28 / $848.15 / $848.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $443.13 / $848.15