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Alaska rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,970.43 / $14,970.43 / $14,970.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $9,812.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $10,106.92
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,501.68 / $11,501.68 / $11,501.68
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,241.18 / $17,210.93 / $25,643.97
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$15,863.68 / $15,863.68 / $16,695.29
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,526.93 / $16,695.29 / $34,428.65
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,501.68 / $11,501.68 / $11,773.23
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,812.54 / $13,581.25 / $21,230.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,528.99 / $8,528.99 / $16,347.24