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Alaska rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $3,388 · 10th–90th $1,549–$10,0000%20%40%10th90th$3,388Professionalmedian $3,548 · 10th–90th $2,455–$11,7490%10%10th90th$3,548$100.0$500.0$2.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,311.31 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $12,022.64
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $4,570.88 / $10,000.00
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,235.94 / $10,000.00 / $16,595.87
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $10,000.00 / $10,471.29
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,128.31 / $10,000.00 / $10,471.29
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $6,918.31
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $3,548.13 / $5,128.61
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,630.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $5,128.61 / $11,748.98