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West Virginia rates for HCPCS L5988

Addition to lower limb prosthesis, vertical shock reducing pylon feature

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.23 / $1,154.23 / $1,154.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,144.05 / $1,154.23 / $1,241.43
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,576.06 / $3,177.71 / $4,119.26
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,530.01 / $1,697.29 / $2,909.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.19 / $1,346.19 / $2,841.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.72 / $1,346.19 / $11,609.07
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,647.70 / $1,647.70 / $1,647.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,149.81 / $1,619.04 / $2,201.89