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Hawaii rates for HCPCS A5114

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.10 / $6.10 / $6.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20.88 / $20.88 / $20.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.58 / $8.58 / $28.93
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $27.54 / $27.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.78 / $26.30 / $36.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.15 / $20.88 / $28.93
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.96 / $21.91 / $25.03