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Alaska rates for HCPCS L5611

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with friction swing phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,205.61 / $2,205.61 / $2,205.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,226.77 / $1,226.77 / $1,226.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.54 / $1,226.77 / $1,307.80
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.83 / $622.83 / $622.83
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,011.68 / $2,392.82 / $3,778.14
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$622.83 / $622.83 / $1,226.77
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$895.54 / $1,307.80 / $2,454.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,217.38 / $1,256.58 / $2,408.46