go back

Wyoming rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $363.08 / $645.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $851.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $660.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $446.68 / $575.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $338.84 / $512.86