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Hawaii 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
$1,862.09 / $2,754.23 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,235.94 / $5,128.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $5,754.40 / $8,128.31
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $6,606.93 / $7,585.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $2,884.03 / $3,311.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $4,466.84 / $7,079.46