go back

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
$175.00 / $175.00 / $175.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$166.45 / $175.00 / $188.22
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$231.97 / $419.54 / $624.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.78 / $249.82 / $335.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.77 / $174.77 / $375.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.58 / $174.77 / $1,573.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.33 / $194.92 / $279.32