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Wyoming rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.25 / $1,389.25 / $2,432.94
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,713.38 / $2,713.38 / $2,713.38
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,713.38 / $2,713.38 / $2,713.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $3,434.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,257.05 / $1,721.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.59 / $1,557.81 / $2,118.58