go back

West Virginia rates for HCPCS L5613

Addition To Lower Extremity Endoskeletal System Above Knee- Knee Disarticulation 4 Bar Linkage With Hydraulic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.35 / $1,442.35 / $1,442.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,436.25 / $1,442.35 / $1,906.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.24 / $3,970.93 / $5,147.50
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,911.93 / $2,116.41 / $3,628.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $3,795.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,902.78 / $15,906.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,467.45 / $2,049.89 / $2,445.75