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Hawaii 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
$730.66 / $730.66 / $730.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,705.90 / $1,705.90 / $1,705.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $2,362.12
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,147.38 / $2,248.56 / $2,248.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.43 / $2,147.38 / $3,006.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,206.73 / $1,705.90 / $2,362.12
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$939.11 / $1,729.79 / $2,043.91