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Hawaii rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $371.54 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $912.01 / $1,288.25
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,096.48
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,047.13 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $416.87 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $724.44 / $1,122.02