go back

Vermont rates for HCPCS L5100

Below knee (BK), molded socket, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,659.59 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $1,737.80 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,258.93 / $1,862.09
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,951.21 / $3,715.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $1,621.81 / $2,187.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,511.89 / $6,918.31