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Hawaii rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.61 / $448.61 / $448.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$974.48 / $974.48 / $974.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$957.73 / $957.73 / $1,349.34
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,226.67 / $1,284.47 / $1,284.47
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$736.00 / $1,226.67 / $1,717.34
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.07 / $974.48 / $1,349.34
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.47 / $988.12 / $1,167.56