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Wyoming rates for HCPCS L5857

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $5,248.07 / $9,120.11
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $10,232.93 / $10,232.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,232.93 / $10,232.93 / $10,232.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $11,481.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $9,120.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $6,025.60 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,168.69 / $4,570.88 / $7,079.46