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Alaska rates for HCPCS L2628

Addition to lower extremity, pelvic control, metal frame, reciprocating hip joint and cables

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,673.46 / $1,673.46 / $1,673.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,179.41 / $1,179.41 / $1,179.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.41 / $1,214.79
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.91 / $607.91 / $607.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,855.85 / $2,390.80 / $2,930.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$607.91 / $607.91 / $1,179.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$860.97 / $1,179.41 / $2,289.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$944.18 / $1,867.97 / $2,436.48