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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
$238.42 / $238.42 / $238.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.34 / $238.42 / $282.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.04 / $607.78 / $850.89
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$305.45 / $340.35 / $523.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $567.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $311.77 / $2,379.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.99 / $348.99 / $348.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.57 / $327.93 / $404.28