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Indiana rates for HCPCS L5987

All Lower Extremity Prosthesis Shank Foot System With Vertical Loading Pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,132.97 / $4,132.97 / $8,684.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,132.97 / $4,240.43 / $4,321.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,860.68 / $7,772.55 / $8,684.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,236.55 / $5,217.74 / $7,164.63
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,548.58 / $9,552.85 / $13,026.62
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,381.75 / $9,552.85 / $11,723.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,042.00 / $6,042.00 / $8,684.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $6,042.00 / $8,908.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,580.25 / $4,332.56 / $5,964.13