go back

Virginia rates for HCPCS L5620

Addition to lower extremity, test socket, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.99 / $175.99 / $177.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.80 / $175.99 / $210.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.68 / $333.68 / $354.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.82 / $202.82 / $257.41
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.00 / $179.00 / $228.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.37 / $209.59 / $209.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $209.59
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.58 / $300.31 / $400.42
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$107.47 / $211.65 / $379.85
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$188.00 / $438.30 / $555.82
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.82 / $251.84 / $417.10
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.82 / $251.84 / $417.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.27 / $219.98 / $250.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$155.15 / $166.47 / $256.52