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Wyoming rates for HCPCS L5795

Addition, exoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $831.76 / $1,513.56
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $851.14 / $1,023.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $645.65 / $1,000.00