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Hawaii rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $398.11 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $501.19 / $707.95
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $575.44 / $602.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $575.44 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $446.68 / $524.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $501.19 / $707.95