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Alaska rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $616.60 / $851.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$575.44 / $575.44 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $588.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $831.76 / $933.25
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $977.24 / $3,090.30
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $933.25 / $977.24
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $933.25 / $954.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $954.99
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $575.44 / $954.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $501.19 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.74 / $478.63 / $1,862.09