go back

New Jersey rates for HCPCS L5990

Addition to lower extremity prosthesis, user adjustable heel height

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$785.55 / $785.55 / $785.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$785.55 / $954.62 / $1,389.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,222.54 / $1,222.54 / $2,137.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.45 / $892.45 / $2,539.13
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,952.91 / $1,966.65 / $2,800.33
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,087.56 / $2,137.66 / $2,137.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,217.37 / $2,608.67 / $3,130.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$963.87 / $1,124.41 / $1,962.49