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West Virginia rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,412.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,513.56 / $2,691.53
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $1,862.09 / $3,890.45
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $3,467.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $5,011.87 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $15,135.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,819.70 / $3,235.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $2,398.83