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Alaska rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,728.86 / $2,728.86 / $2,728.86
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,743.07 / $1,743.07 / $1,743.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $1,272.44 / $1,272.44
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.44 / $898.44 / $898.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,960.49 / $3,185.83 / $4,674.47
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$898.44 / $898.44 / $1,743.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.44 / $2,487.15 / $3,651.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,506.19 / $1,554.70 / $2,979.83