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West Virginia rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,869.96 / $13,869.96 / $13,869.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,869.96 / $13,869.96 / $14,917.83
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,939.18 / $38,185.44 / $49,499.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,385.59 / $20,396.05 / $34,964.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,200.25 / $16,200.25 / $34,145.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,826.18 / $16,200.25 / $138,969.38
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,099.81 / $19,099.81 / $19,799.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$29,383.10 / $29,383.10 / $29,383.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,229.73 / $17,091.93 / $23,518.89