go back

Alaska rates for HCPCS L5647

Addition To Lower Extremity Below Knee Suction Socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.84 / $1,275.84 / $1,275.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$596.58 / $596.58 / $596.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $435.50 / $435.50
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.50 / $307.50 / $307.50
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$907.01 / $1,384.15 / $2,185.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.50 / $307.50 / $596.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$435.50 / $708.09 / $1,707.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.41 / $717.65 / $717.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.20 / $726.88 / $1,393.19