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West Virginia rates for HCPCS L5105

Below knee (BK), plastic socket, joints and thigh lacer, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,290.87 / $3,630.78
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $5,623.41
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $5,011.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $7,585.78 / $7,585.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $22,908.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,754.23 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,884.03 / $3,801.89