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Alaska rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $2,818 · 10th–90th $1,380–$4,7860%20%40%10th90th$2,818Professionalmedian $3,162 · 10th–90th $2,344–$5,8880%10%10th90th$3,162$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $3,090.30 / $4,265.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $5,128.61
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $3,467.37 / $4,786.30
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $4,570.88 / $15,488.17
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,570.88 / $4,786.30
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $4,570.88 / $4,786.30
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $4,786.30
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $2,884.03 / $4,466.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,344.23 / $10,471.29