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Wyoming rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.99 / $118.99 / $208.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$232.39 / $232.39 / $232.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.39 / $232.39 / $232.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.31 / $122.31 / $215.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.29 / $89.29 / $122.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.26 / $97.65 / $150.47