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Wyoming rates for HCPCS L5968

Addition to lower limb prosthesis, multiaxial ankle with swing phase active dorsiflexion feature

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,217.51 / $2,217.51 / $3,883.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,331.07 / $4,331.07 / $4,331.07
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,331.07 / $4,331.07 / $4,331.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,448.80 / $2,448.80 / $4,801.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,787.62 / $1,787.62 / $2,448.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,767.07 / $2,606.83 / $3,012.78