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Hawaii rates for HCPCS L5321

Above knee (AK), molded socket, open end, SACH foot, endoskeletal system, single axis knee

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,449.67 / $1,449.67 / $1,449.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,225.87 / $5,225.87 / $5,225.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,481.10 / $2,481.10 / $7,236.12
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,578.29 / $6,888.26 / $6,888.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,946.97 / $6,578.29 / $9,209.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,600.65 / $2,600.65 / $2,668.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,554.80 / $5,225.87 / $7,236.12
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,395.42 / $5,480.67 / $6,261.32