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Hawaii rates for HCPCS L5828

Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,522.04 / $1,522.04 / $1,522.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,860.54 / $3,860.54 / $3,860.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,117.90 / $5,345.59 / $5,345.59
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,859.63 / $5,088.62 / $5,088.62
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,915.78 / $4,859.63 / $6,803.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,587.58 / $3,860.54 / $5,345.59
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,125.28 / $3,914.61 / $4,625.47