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Indiana rates for HCPCS L5979

All lower extremity prostheses, multiaxial ankle, dynamic response foot, one-piece system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,432.44 / $1,432.44 / $3,009.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,355.48 / $1,461.09 / $1,522.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,377.83 / $2,693.87 / $3,009.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,468.33 / $1,660.84 / $2,291.94
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,257.42 / $3,310.90 / $4,213.87
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,558.42 / $3,310.90 / $4,063.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,711.28 / $1,711.28 / $3,009.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.23 / $1,711.28 / $3,087.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$910.86 / $1,501.61 / $2,105.41