go back

Hawaii 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
$3,715.35 / $4,677.35 / $7,244.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $6,025.60 / $7,244.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $8,128.31 / $11,481.54
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,332.54 / $9,332.54 / $9,332.54
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $9,332.54 / $10,715.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $5,248.07 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $6,456.54 / $10,000.00