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West Virginia rates for HCPCS L5631

Addition to lower extremity, above knee (AK) or knee disarticulation, acrylic socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.86 / $315.86 / $315.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$300.42 / $315.86 / $341.75
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$418.70 / $791.04 / $1,127.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.15 / $450.91 / $632.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $682.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $329.53 / $2,860.28
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.96 / $434.96 / $434.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.27 / $386.49 / $535.60