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Hawaii rates for HCPCS L5160

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,684.72 / $1,684.72 / $1,684.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,822.83 / $5,822.83 / $5,822.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,670.30 / $3,670.30 / $8,062.70
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,329.73 / $7,675.11 / $7,675.11
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,397.84 / $7,329.73 / $10,261.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,499.92 / $7,256.43 / $8,062.70
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,205.55 / $5,904.38 / $6,976.55