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Alaska rates for HCPCS L5990

Addition to lower extremity prosthesis, user adjustable heel height

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,871.89 / $1,871.89 / $1,871.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,222.54 / $1,222.54 / $1,222.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.45 / $892.45 / $892.45
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.14 / $630.14 / $630.14
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,030.78 / $2,030.78 / $3,206.49
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.14 / $630.14 / $1,222.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$892.45 / $1,585.42 / $2,505.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,033.18 / $1,066.46 / $2,044.04