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Wyoming rates for HCPCS L5105

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,398.83 / $4,466.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $4,466.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,187.76 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $2,754.23 / $3,630.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,089.30 / $3,235.94