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Alaska rates for HCPCS L5638

Addition to lower extremity, below knee (BK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.57 / $753.57 / $753.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$503.81 / $503.81 / $503.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.78 / $367.78 / $367.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.13 / $188.13 / $188.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.03 / $817.54 / $1,290.85
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.13 / $188.13 / $503.81
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.78 / $491.09 / $1,008.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$415.93 / $429.32 / $822.87