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Hawaii rates for HCPCS L5700

Replacement, socket, below knee (BK), molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,995.26 / $3,090.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,388.44 / $4,786.30
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,890.45 / $3,890.45 / $3,890.45
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $3,890.45 / $4,466.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,238.72 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,754.23 / $4,168.69