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Virginia rates for HCPCS L5624

Addition To Lower Extremity Test Socket Above Knee

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$256.43 / $256.43 / $259.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.34 / $256.43 / $275.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$486.22 / $486.22 / $516.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.64 / $264.64 / $341.93
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.00 / $261.00 / $332.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$259.89 / $311.77 / $311.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $227.60 / $311.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.35 / $437.60 / $583.46
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.54 / $307.00 / $545.53
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $638.65 / $809.88
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.38 / $365.39 / $607.78
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.38 / $365.39 / $607.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$219.23 / $242.57 / $347.99