go back

West Virginia rates for HCPCS L5679

Addition To Lower Extremity Below Knee/Above Kneecustom Fabricated Fromexisting Mold Or Prefabric Ated Socket Insert Silicone Gel Elastomeric Or Equal Not For Use With Locking Mechanism

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$344.57 / $344.57 / $344.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.57 / $344.57 / $383.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$462.26 / $948.63 / $1,229.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.75 / $497.82 / $853.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.05 / $440.05 / $857.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.24 / $440.05 / $3,595.38
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.91 / $912.91 / $912.91
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.58 / $446.58 / $548.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.56 / $502.25 / $610.36