go back

Hawaii 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
$6,478.30 / $6,478.30 / $6,478.30
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,581.25 / $13,581.25 / $13,581.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $18,805.58
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,034.65 / $4,034.65 / $4,034.65
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,967.19 / $17,095.98 / $23,934.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,537.40 / $15,984.74 / $18,805.58
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,771.46 / $14,243.42 / $16,272.21