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Wyoming rates for HCPCS L5631

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.68 / $263.68 / $461.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$515.00 / $515.00 / $515.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.00 / $515.00 / $515.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $580.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $240.56 / $329.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.79 / $350.79 / $405.42