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West Virginia rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.92 / $2,238.92 / $2,238.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.92 / $2,238.92 / $2,408.08
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,967.85 / $6,332.29 / $8,218.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,967.85 / $3,196.14 / $5,479.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,853.06 / $2,853.06 / $5,988.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,853.06 / $25,100.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,277.89 / $3,010.10 / $3,796.48