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Illinois rates for HCPCS L5988

Addition to lower limb prosthesis, vertical shock reducing pylon feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,193.63 / $1,193.63 / $1,193.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.17 / $1,193.63 / $1,978.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,881.08 / $4,874.28 / $20,750.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,832.85 / $1,832.85 / $1,832.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.19 / $1,346.19 / $2,639.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.72 / $1,346.19 / $2,796.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,049.89 / $2,676.06 / $3,376.30
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,135.13 / $3,135.13 / $3,135.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,469.61 / $2,099.44 / $2,204.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.67 / $1,203.14 / $2,065.40