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Alaska rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,685.05 / $5,685.05 / $5,685.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,853.06 / $2,853.06 / $2,853.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,853.06 / $2,938.65
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,470.57 / $1,470.57 / $1,470.57
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,608.41 / $6,167.61 / $9,738.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,470.57 / $1,470.57 / $2,853.06
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,938.65 / $5,794.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,238.90 / $3,238.90 / $6,207.88