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West Virginia rates for HCPCS L5859

Addition to lower extremity prosthesis, endoskeletal knee-shin system, powered and programmable flexion/extension assist control, includes any type motor(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,383.10 / $8,383.10 / $8,383.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,309.19 / $8,383.10 / $9,016.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,447.00 / $23,079.57 / $29,917.97
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,112.39 / $12,327.54 / $21,132.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $20,637.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $9,812.54 / $84,284.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,528.99 / $11,923.25 / $16,560.08