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Hawaii rates for HCPCS L5979

All lower extremity prostheses, multiaxial ankle, dynamic response foot, one-piece system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,621.81 / $2,511.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $1,698.24 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $2,951.21 / $4,168.69
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $3,388.44
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $3,388.44 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $1,862.09 / $2,187.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,290.87 / $3,630.78