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West Virginia rates for HCPCS L5972

All lower extremity prostheses, foot, flexible keel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.42 / $207.42 / $207.42
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.42 / $207.42 / $239.66
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.95 / $571.04 / $740.25
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.95 / $318.73 / $546.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.77 / $293.77 / $557.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.45 / $293.77 / $2,338.28
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$296.10 / $296.10 / $296.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$479.40 / $479.40 / $479.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$211.03 / $294.79 / $351.72