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West Virginia rates for HCPCS L5705

Custom shaped protective cover, above knee (AK)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$633.84 / $633.84 / $633.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$633.84 / $633.84 / $681.72
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$840.20 / $1,615.76 / $2,262.07
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.69 / $904.83 / $1,379.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.43 / $895.43 / $1,428.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.66 / $895.43 / $5,988.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$631.40 / $777.30 / $1,074.78