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Missouri 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
$3,948.17 / $5,840.01 / $6,027.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,948.17 / $4,523.95 / $8,225.36
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,789.98 / $5,789.98 / $5,789.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,641.76 / $9,073.85 / $39,890.36
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,318.31 / $5,217.74 / $6,991.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,042.00 / $6,042.00 / $6,042.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $4,410.66 / $7,085.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,948.17 / $6,964.57 / $40,507.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,225.32 / $4,619.34 / $7,671.80
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,032.19 / $8,032.19 / $8,032.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,225.32 / $4,311.28 / $6,119.67