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Wyoming rates for HCPCS L5614

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,047.13 / $1,819.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,202.26 / $1,659.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$812.83 / $912.01 / $1,412.54