go back

Wyoming rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,843.77 / $1,843.77 / $3,228.92
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,601.10 / $3,601.10 / $3,601.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,601.10 / $3,601.10 / $3,601.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,902.78 / $1,902.78 / $3,939.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,389.03 / $1,389.03 / $1,902.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,326.30 / $1,956.60 / $2,261.29