go back

Wyoming rates for HCPCS L5624

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.86 / $218.86 / $383.28
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.46 / $427.46 / $427.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.46 / $427.46 / $427.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$311.77 / $311.77 / $480.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$227.60 / $227.60 / $311.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.76 / $217.69 / $335.46