go back

Vermont rates for HCPCS A5114

Leg Strap; Foam Or Fabric Replacement Only Per Set (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.58 / $7.17 / $7.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.60 / $8.60 / $8.60
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $6.38 / $7.74
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.95 / $7.51 / $7.51
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.95 / $7.21 / $7.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.54 / $6.74 / $12.28