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Vermont rates for HCPCS L5500

Initial, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, plaster socket, direct formed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $933.25 / $1,023.29
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $707.95 / $1,000.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,513.56 / $2,041.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $1,023.29 / $1,230.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $1,318.26 / $3,630.78