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Virginia rates for HCPCS L5652

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.98 / $275.98 / $278.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.51 / $275.98 / $298.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$523.28 / $523.28 / $555.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$317.41 / $317.41 / $398.70
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.00 / $293.25 / $357.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$279.70 / $338.50 / $338.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$247.11 / $247.11 / $338.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$366.30 / $470.95 / $627.94
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$168.53 / $331.91 / $595.66
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$294.00 / $687.34 / $871.62
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$286.69 / $393.25 / $654.10
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.69 / $393.25 / $654.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.17 / $261.06 / $402.28