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West Virginia rates for HCPCS L5671

Addition to lower extremity, below knee (BK)/above knee (AK) suspension locking mechanism (shuttle, lanyard, or equal), excludes socket insert

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$292.75 / $292.75 / $292.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.16 / $292.75 / $314.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$448.62 / $805.98 / $1,044.79
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$388.06 / $483.13 / $828.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.63 / $380.63 / $811.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$277.86 / $380.63 / $3,400.08
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.42 / $379.42 / $417.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$297.85 / $416.06 / $496.41