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Alaska rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,298.34 / $5,298.34 / $5,298.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,249.00 / $3,249.00 / $3,249.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $3,249.00 / $3,346.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.50 / $1,357.50 / $1,357.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,649.13 / $5,748.08 / $9,075.92
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,357.50 / $1,357.50 / $3,249.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $3,346.47 / $5,349.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,924.40 / $3,018.58 / $5,785.62