go back

Wyoming rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $177.83 / $323.59
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $309.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$218.78 / $218.78 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $162.18 / $316.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $208.93 / $257.04
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $158.49 / $245.47