go back

Alaska rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.35 / $400.35 / $400.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.54 / $274.54 / $274.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $200.41 / $200.41
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.13 / $140.13 / $140.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.33 / $477.02 / $685.79
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.13 / $140.13 / $274.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $372.40 / $535.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.08 / $228.08 / $437.16