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West Virginia rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$301.35 / $301.35 / $301.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$301.35 / $301.35 / $398.26
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$399.46 / $829.64 / $1,075.46
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.46 / $430.19 / $737.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$452.18 / $452.18 / $796.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$330.09 / $452.18 / $3,338.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$696.49 / $696.49 / $696.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.58 / $428.28 / $510.99