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Alaska rates for HCPCS L5973

Endoskeletal ankle foot system, microprocessor controlled feature, dorsiflexion and/or plantar flexion control, includes power source

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,220.18 / $12,589.25 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $12,882.50 / $12,882.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $9,332.54 / $13,489.63
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $18,197.01 / $19,952.62
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,952.62 / $19,952.62 / $63,095.73
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,197.01 / $20,417.38 / $20,892.96
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,595.87 / $20,417.38 / $20,892.96
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $6,309.57 / $20,892.96
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $12,882.50 / $19,498.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,302.69 / $12,302.69 / $14,125.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,232.93 / $45,708.82