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Alaska rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$706.56 / $706.56 / $706.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $379.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $276.69
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $188.72 / $188.72
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.38 / $766.54 / $1,210.32
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.72 / $188.72 / $379.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $510.87 / $945.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.99 / $402.55 / $771.55