go back

West Virginia rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.76 / $181.76 / $181.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.16 / $181.76 / $195.49
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$268.18 / $500.42 / $648.69
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.94 / $288.81 / $495.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $487.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $2,042.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.93 / $244.37 / $290.11