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Alaska rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,074.16 / $1,074.16 / $1,074.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.73 / $957.73 / $957.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $1,020.99
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.30 / $352.30 / $352.30
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.35 / $1,165.33 / $1,840.01
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.30 / $352.30 / $957.73
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $1,285.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.87 / $611.97 / $1,172.94