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Alaska rates for HCPCS L8043

Upper facial prosthesis, provided by a nonphysician

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,691.53 / $4,365.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,090.30 / $3,715.35
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $4,365.16 / $4,897.79
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,897.79 / $13,803.84
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $4,897.79 / $5,128.61
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $4,897.79 / $5,011.87
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $4,786.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $3,311.31 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $2,511.89 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,511.89 / $9,772.37