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Wyoming rates for HCPCS L5828

Addition, endoskeletal knee-shin system, single axis, fluid swing and stance phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,995.26 / $3,388.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $4,265.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $2,238.72 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $1,698.24 / $2,630.27