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Alaska rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,662.08 / $3,662.08 / $3,662.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $1,902.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,902.78 / $1,959.86
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.36 / $947.36 / $947.36
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,794.36 / $3,972.93 / $6,273.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$947.36 / $947.36 / $1,902.78
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,959.86 / $3,446.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,021.27 / $2,086.37 / $3,998.87