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Alaska rates for HCPCS L5645

Addition to lower extremity, below knee (BK), flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,007.68 / $1,007.68 / $1,007.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.09 / $694.09 / $694.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.69 / $694.09 / $813.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.44 / $308.44 / $308.44
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$909.78 / $1,093.21 / $1,726.13
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.44 / $308.44 / $694.09
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.69 / $710.26 / $1,122.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.10 / $574.10 / $1,100.34