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Hawaii rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,441.66 / $10,441.66 / $10,441.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,876.27 / $22,876.27 / $22,876.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,200.25 / $16,200.25 / $31,676.11
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28,796.46 / $30,153.35 / $30,153.35
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,157.52 / $28,796.46 / $40,315.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,068.37 / $22,876.27 / $31,676.11
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,068.37 / $23,991.62 / $27,408.91