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West Virginia rates for HCPCS L5629

Addition to lower extremity, below knee, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$242.39 / $242.39 / $242.39
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.55 / $242.39 / $260.70
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$321.31 / $572.15 / $865.06
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$267.00 / $346.02 / $457.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$248.05 / $248.05 / $492.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.08 / $248.05 / $2,063.67
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.16 / $314.16 / $386.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$241.46 / $286.64 / $429.38