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West Virginia rates for HCPCS L5706

Custom Shaped Protective Cover Knee Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$618.22 / $618.22 / $618.22
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$618.22 / $618.22 / $664.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$819.50 / $1,575.96 / $2,206.35
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$788.80 / $882.54 / $1,352.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$957.73 / $957.73 / $1,402.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$699.14 / $957.73 / $5,876.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$595.23 / $595.23 / $595.23
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$615.90 / $762.30 / $1,048.30