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Hawaii 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
$7,535.85 / $7,535.85 / $7,535.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,438.18 / $16,438.18 / $16,438.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,752.32 / $12,752.32 / $22,761.49
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,692.25 / $21,667.28 / $21,667.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,484.58 / $20,692.25 / $28,969.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,614.49 / $19,347.25 / $22,761.49
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,668.40 / $17,239.65 / $19,695.21