go back

West Virginia rates for HCPCS L5656

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.80 / $232.80 / $232.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.49 / $232.80 / $250.39
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$308.58 / $610.90 / $830.83
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$308.58 / $332.33 / $543.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $575.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $2,414.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$236.85 / $310.29 / $394.75