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Wyoming rates for HCPCS L5971

All lower extremity prostheses, solid ankle cushion heel (SACH) foot, replacement only

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$136.26 / $136.26 / $238.63
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$266.13 / $266.13 / $266.13
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$266.13 / $266.13 / $266.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$159.21 / $159.21 / $276.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.22 / $116.22 / $159.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.91 / $121.61 / $187.40