go back

Alaska rates for HCPCS L5696

Addition to lower extremity, above knee (AK) or knee disarticulation, pelvic joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.87 / $292.87 / $292.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.76 / $138.76 / $138.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $138.76 / $147.91
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $71.52 / $71.52
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.29 / $317.74 / $501.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.52 / $71.52 / $138.76
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $138.76 / $281.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.85 / $166.85 / $319.80