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Hawaii rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.90 / $186.90 / $186.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.62 / $247.62 / $247.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.05 / $248.05 / $342.88
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.70 / $326.39 / $326.39
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.03 / $311.70 / $436.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.22 / $291.45 / $342.88
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.30 / $251.09 / $296.69