go back

West Virginia rates for HCPCS L5250

Hip disarticulation, Canadian type; molded socket, hip joint, single axis constant friction knee, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,019.95 / $3,019.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $3,311.31 / $5,623.41
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,073.80 / $8,317.64
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $7,413.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $11,481.54 / $11,481.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $34,673.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,168.69 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,981.07 / $5,128.61