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West Virginia rates for HCPCS L5976

All Lower Extremity Prostheses Energy Storing Foot (Seattle Carbon Copy Ii Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.60 / $329.60 / $329.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.60 / $329.60 / $400.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.91 / $907.43 / $1,176.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.91 / $470.52 / $806.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.01 / $420.01 / $876.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.61 / $420.01 / $3,672.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $468.43 / $558.89