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West Virginia rates for HCPCS L5974

All lower extremity prostheses, foot, single axis ankle/foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $173.78 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $165.96 / $234.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $181.97 / $380.19
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $194.98 / $338.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $524.81 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $186.21 / $323.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $208.93 / $295.12