go back

West Virginia rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.13 / $335.13 / $335.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.13 / $335.13 / $360.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$444.24 / $877.46 / $1,196.04
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$400.58 / $478.42 / $686.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$493.58 / $493.58 / $757.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.31 / $493.58 / $3,172.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$648.55 / $648.55 / $648.55
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.22 / $410.07 / $534.91