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Alaska rates for HCPCS L5987

All lower extremity prostheses, shank foot system with vertical loading pylon

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,496.60 / $7,496.60 / $7,496.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,042.00 / $6,042.00 / $6,042.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $6,042.00 / $7,085.17
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,498.65 / $2,498.65 / $2,498.65
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,052.40 / $8,132.94 / $12,841.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,498.65 / $2,498.65 / $6,042.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,410.66 / $6,286.46 / $8,356.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,137.72 / $4,270.97 / $8,186.05