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Alaska rates for HCPCS L5105

Below knee (BK), plastic socket, joints and thigh lacer, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,409.92 / $5,409.92 / $5,409.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,006.81 / $3,006.81 / $3,006.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,194.96 / $3,006.81 / $3,097.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,342.91 / $1,342.91 / $1,342.91
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,496.29 / $5,869.14 / $9,267.06
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,342.91 / $1,342.91 / $3,006.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,194.96 / $3,097.01 / $5,291.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,985.99 / $3,082.16 / $5,907.47