go back

West Virginia rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $85.11 / $134.90
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$104.71 / $104.71 / $213.80
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $112.20 / $190.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $288.40 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.44 / $72.44 / $870.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$102.33 / $104.71 / $186.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $104.71 / $138.04