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Alaska rates for HCPCS L5707

Custom shaped protective cover, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,434.44 / $1,434.44 / $1,434.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,232.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,232.20 / $1,313.59
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.20 / $478.20 / $478.20
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.20 / $1,608.32 / $2,457.15
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$478.20 / $478.20 / $1,232.20
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,255.59 / $1,726.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$817.24 / $817.24 / $1,566.37