go back

Alaska rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,203.33 / $1,203.33 / $1,203.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $702.38 / $702.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $702.38 / $748.77
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $362.03 / $362.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.44 / $1,305.49 / $2,061.30
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $362.03 / $702.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $748.77 / $1,288.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.18 / $685.57 / $1,314.00