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New Mexico 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
$1,510.78 / $1,510.78 / $1,510.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,510.78 / $2,062.34 / $10,438.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,711.28 / $1,711.28 / $1,711.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.23 / $1,711.28 / $1,711.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,190.92 / $2,738.66 / $4,107.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.05 / $882.05 / $2,058.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.23 / $1,711.28 / $3,787.86
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,263.25 / $1,366.29 / $2,058.57