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Alaska rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $141 · 10th–90th $71–$3310%20%40%10th90th$141Professionalmedian $178 · 10th–90th $120–$4790%10%10th90th$178$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $165.96 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $407.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $229.09 / $331.13
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $331.13 / $1,122.02
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $338.84 / $354.81
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $338.84 / $354.81
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$70.79 / $70.79 / $302.00
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $141.25 / $275.42
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $162.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $173.78 / $524.81