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Oklahoma rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,745.98 / $3,745.98 / $3,745.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,745.98 / $4,281.12 / $4,321.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,730.64 / $8,730.64 / $8,730.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,233.06 / $7,644.86 / $7,644.86
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 / $6,042.00 / $6,042.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,498.65 / $5,243.65 / $40,507.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,580.25 / $5,114.47 / $8,838.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,580.25 / $4,161.43 / $5,830.18