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Alaska rates for HCPCS L5855

Addition, endoskeletal system, hip disarticulation, mechanical hip extension assist

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $302.00 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $173.78 / $245.47
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $398.11 / $436.52
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $478.63 / $1,479.11
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $446.68 / $467.74
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $446.68 / $457.09
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $501.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $239.88 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.47 / $245.47 / $281.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $229.09 / $891.25