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Hawaii rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Facilitymedian $2,754 · 10th–90th $2,630–$3,9810%50%10th90th$2,754Professionalmedian $2,951 · 10th–90th $1,738–$5,1290%20%10th90th$2,951$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,344.23 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $4,677.35 / $6,309.57
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,128.61 / $5,128.61
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,090.30 / $5,128.61 / $5,888.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,691.53 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $3,019.95 / $5,495.41