go back

Alaska rates for HCPCS L5614

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,758.51 / $1,758.51 / $1,758.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $1,317.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,317.79 / $1,357.32
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.11 / $586.11 / $586.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,888.88 / $1,907.78 / $3,012.29
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$586.11 / $586.11 / $1,317.79
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $1,357.32 / $1,960.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,001.86 / $1,001.86 / $4,391.72