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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
$1,029.74 / $1,029.74 / $1,803.35
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,011.21 / $2,011.21 / $2,011.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,011.21 / $2,011.21 / $2,011.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.79 / $1,317.79 / $2,229.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.99 / $961.99 / $1,317.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$820.56 / $907.89 / $1,399.02