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Virginia rates for HCPCS L5676

Additions to lower extremity, below knee (BK), knee joints, single axis, pair

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.38 / $229.38 / $231.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.37 / $229.38 / $261.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$434.94 / $434.94 / $461.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.39 / $263.39 / $344.33
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.00 / $233.00 / $297.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.77 / $271.77 / $271.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.39 / $198.39 / $271.77
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.45 / $391.45 / $521.92
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.08 / $275.88 / $495.11
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.00 / $571.29 / $724.47
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$238.29 / $326.85 / $543.67
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.29 / $326.85 / $543.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.62 / $216.98 / $334.37