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West Virginia rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.88 / $239.88 / $239.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $239.88 / $407.38
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $281.84 / $588.84
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $229.09 / $2,398.83
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $338.84 / $398.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $288.40 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $302.00 / $407.38