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Alaska rates for HCPCS L5656

Addition to lower extremity, socket insert, knee disarticulation (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.54 / $535.54 / $535.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $335.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $245.16
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.40 / $143.40 / $143.40
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$563.96 / $581.01 / $917.39
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$143.40 / $143.40 / $335.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $440.27 / $695.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.11 / $305.11 / $584.79