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Virginia rates for HCPCS L5985

All endoskeletal lower extremity prostheses, dynamic prosthetic pylon

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.49 / $175.49 / $177.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.04 / $175.49 / $184.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.74 / $332.74 / $353.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$187.23 / $187.23 / $238.49
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.75 / $185.75 / $227.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.86 / $220.51 / $220.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.97 / $160.97 / $220.51
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.92 / $299.47 / $399.29
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$98.71 / $205.32 / $382.65
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$193.00 / $437.06 / $554.24
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$182.30 / $251.86 / $416.64
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.30 / $251.86 / $416.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.90 / $166.00 / $244.55