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Vermont rates for HCPCS L5150

Knee disarticulation (or through knee), molded socket, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,103.96 / $2,103.96 / $2,427.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,168.89 / $3,249.00 / $3,249.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $3,249.00 / $3,346.47
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,168.89 / $3,249.00 / $3,249.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,371.77 / $3,249.00 / $3,346.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.97 / $3,168.20 / $4,984.28