go back

Hawaii rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $398.11 / $645.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $562.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $630.96 / $891.25
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $724.44 / $758.58
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $724.44 / $831.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $389.05 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $489.78 / $776.25