go back

Alaska rates for HCPCS L5685

Addition to lower extremity prosthesis, below knee, suspension/sealing sleeve, with or without valve, any material, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.16 / $132.16 / $132.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.03 / $100.03 / $100.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.02 / $100.03 / $106.64
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.49 / $44.49 / $44.49
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.37 / $143.37 / $226.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$44.49 / $44.49 / $100.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.02 / $106.64 / $148.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.94 / $75.29 / $144.31