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Michigan rates for HCPCS L5984

All Endoskeletal Lower Extremity Prostheses Axial Rotation Unit With Or Without Adjustability (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.29 / $443.29 / $443.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.70 / $443.29 / $443.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.22 / $776.22 / $776.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.85 / $2,340.77 / $4,263.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$737.41 / $776.22 / $1,047.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.43 / $447.01 / $504.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.98 / $620.98 / $620.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.25 / $427.25 / $427.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.25 / $427.25 / $900.00
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$443.29 / $560.95 / $560.95
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.16 / $560.95 / $815.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.00 / $574.40 / $660.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.26 / $371.09 / $555.55