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West Virginia rates for HCPCS L5990

Addition to lower extremity prosthesis, user adjustable heel height

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,071.52 / $1,862.09
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $2,951.21
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $2,630.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $3,467.37 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $891.25 / $10,471.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $2,238.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,348.96 / $1,778.28