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Wyoming rates for HCPCS L5858

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,549.93 / $11,481.54 / $19,952.62
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,387.21 / $22,387.21 / $22,387.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,387.21 / $22,387.21 / $22,387.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,454.40 / $14,454.40 / $25,118.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $10,715.19 / $19,952.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $13,182.57 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,120.11 / $10,000.00 / $15,488.17