go back

Virginia rates for HCPCS L5962

Addition, endoskeletal system, below knee (BK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.08 / $372.08 / $376.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$344.48 / $372.08 / $402.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.49 / $705.49 / $749.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$455.05 / $455.05 / $568.85
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$378.00 / $378.00 / $482.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$377.11 / $448.56 / $448.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.45 / $327.45 / $448.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.84 / $634.94 / $846.59
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.22 / $435.33 / $811.31
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.00 / $926.67 / $1,175.13
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$386.52 / $532.42 / $881.86
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.52 / $532.42 / $881.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.15 / $470.15 / $470.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$327.84 / $351.96 / $542.36