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Alaska rates for HCPCS A5114

Leg strap; foam or fabric, replacement only, per set

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.02 / $7.08 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.59 / $7.59 / $7.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $6.31 / $7.76
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $12.30 / $23.99
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.23 / $23.99 / $60.26
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.96 / $23.99 / $23.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.50 / $23.99 / $30.20
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.39 / $3.39 / $14.45
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.31 / $9.33 / $60.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.17 / $4.17 / $4.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $23.44 / $42.66