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West Virginia rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$249.89 / $249.89 / $249.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.67 / $249.89 / $268.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.24 / $637.00 / $891.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.58 / $356.72 / $522.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.54 / $274.54 / $579.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.41 / $200.41 / $2,429.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $305.76 / $423.73