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New York rates for HCPCS L8417

Prosthetic sheath/sock, including a gel cushion layer, below knee (BK) or above knee (AK), each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.51 / $38.50 / $71.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.51 / $39.09 / $55.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.48 / $90.25 / $176.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.54 / $54.54 / $145.34
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$68.56 / $73.72 / $73.72
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.72 / $73.72 / $73.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.66 / $50.66 / $50.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $36.97 / $50.66
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$88.48 / $199.08 / $332.00
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.68 / $65.48 / $159.26
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$32.11 / $32.11 / $32.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $53.19 / $63.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.76 / $71.76 / $71.76
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.66 / $50.66 / $555.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.97 / $50.66 / $131.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.43 / $53.93 / $80.93
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$53.19 / $53.19 / $55.28
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.11 / $53.19 / $56.51