go back

Alaska rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.32 / $478.32 / $478.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$362.03 / $362.03 / $362.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.27 / $362.03 / $385.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.02 / $161.02 / $161.02
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.91 / $518.91 / $819.35
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$161.02 / $161.02 / $362.03
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.27 / $385.94 / $538.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.01 / $272.51 / $522.30