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Hawaii 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
$473.58 / $473.58 / $473.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,171.88 / $1,171.88 / $1,171.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$908.11 / $1,622.67 / $1,622.67
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,475.15 / $1,544.66 / $1,544.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$885.09 / $1,475.15 / $2,065.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.83 / $1,171.88 / $1,622.67
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.14 / $1,188.29 / $1,404.07