go back

Alaska rates for HCPCS L5699

All lower extremity prostheses, shoulder harness

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.14 / $341.14 / $341.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$169.96 / $169.96 / $169.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.07 / $124.07 / $124.07
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.08 / $72.08 / $72.08
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.30 / $370.09 / $584.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.08 / $72.08 / $169.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.07 / $218.82 / $345.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.29 / $194.35 / $372.51