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Wyoming rates for HCPCS L5230

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,043.95 / $3,043.95 / $5,330.78
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,945.21 / $5,945.21 / $5,945.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,945.21 / $5,945.21 / $5,945.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,853.06 / $2,853.06 / $5,359.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,082.73 / $2,082.73 / $2,853.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,058.79 / $3,037.18 / $3,510.16