go back

Wyoming rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,982.49 / $1,982.49 / $3,471.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,872.04 / $3,872.04 / $3,872.04
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,872.04 / $3,872.04 / $3,872.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,728.17 / $2,728.17 / $4,656.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.56 / $1,991.56 / $3,936.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.82 / $2,637.44 / $3,048.16