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Wyoming rates for HCPCS L5628

Addition To Lower Extremity Test Socket Hemipelvectomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.75 / $289.75 / $507.42
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$565.91 / $565.91 / $565.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$565.91 / $565.91 / $565.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$499.82 / $499.82 / $668.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.87 / $364.87 / $499.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $382.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.30 / $289.10 / $445.50