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Alaska rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,208.02 / $1,208.02 / $1,208.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$908.11 / $908.11 / $908.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $662.92 / $662.92
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.05 / $415.05 / $415.05
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,224.26 / $1,310.56 / $2,069.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$415.05 / $415.05 / $908.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.92 / $955.76 / $1,616.65
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.77 / $688.24 / $1,319.13