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Virginia rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.00 / $440.00 / $444.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.90 / $440.00 / $460.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$834.29 / $834.29 / $886.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.88 / $468.88 / $601.76
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$447.00 / $447.00 / $447.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $572.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $572.20
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.00 / $750.86 / $1,001.15
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.19 / $513.10 / $936.07
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.00 / $1,095.83 / $1,389.66
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.08 / $626.97 / $1,042.85
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.08 / $626.97 / $1,042.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.88 / $416.21 / $597.11