go back

Vermont rates for HCPCS L5210

Above knee (AK), short prosthesis, no knee joint (stubbies), with foot blocks, no ankle joints, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,544.99 / $1,544.99 / $1,782.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.89 / $1,819.89 / $2,327.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.52 / $1,819.89 / $1,940.10
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.89 / $1,819.89 / $2,327.01
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.52 / $1,819.89 / $1,940.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,776.27 / $1,776.27 / $1,776.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,095.11 / $1,875.46 / $3,660.09