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Hawaii rates for HCPCS L5986

All lower extremity prostheses, multiaxial rotation unit (MCP or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$279.50 / $279.50 / $279.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.08 / $1,071.08 / $1,071.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$663.31 / $663.31 / $1,483.12
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.29 / $1,411.82 / $1,411.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$808.97 / $1,348.29 / $1,887.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$554.65 / $939.62 / $1,483.12
University Health Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.65 / $1,086.09 / $1,283.32