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West Virginia rates for HCPCS L5650

Additions to lower extremity, total contact, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$287.32 / $287.32 / $287.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.77 / $287.32 / $309.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.86 / $791.02 / $1,025.40
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.86 / $410.16 / $703.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.03 / $379.03 / $768.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.69 / $276.69 / $3,222.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.32 / $408.34 / $487.20