go back

Wyoming rates for HCPCS L5220

Above knee (AK), short prosthesis, no knee joint (stubbies), with articulated ankle/foot, dynamically aligned, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.63 / $1,808.63 / $3,167.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,532.47 / $3,532.47 / $3,532.47
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,532.47 / $3,532.47 / $3,532.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,482.86 / $2,482.86 / $4,025.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,812.49 / $1,812.49 / $2,482.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,247.08 / $2,182.50 / $2,182.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,492.75 / $1,651.61 / $2,545.08