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Wyoming rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,245.40 / $1,245.40 / $2,181.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,432.42 / $2,432.42 / $2,432.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,432.42 / $2,432.42 / $2,432.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $2,054.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $852.13 / $1,167.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$842.33 / $1,242.64 / $1,436.15