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Hawaii rates for HCPCS L5590

Preparatory, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, laminated socket, molded to model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,176.66 / $1,176.66 / $1,176.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,414.38 / $3,414.38 / $3,414.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,289.62 / $4,727.79 / $4,727.79
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,297.99 / $4,500.51 / $4,500.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,578.79 / $4,297.99 / $6,017.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,202.73 / $4,255.01 / $4,727.79
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,879.66 / $2,685.23 / $4,090.90