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Vermont rates for HCPCS L5614

Addition to lower extremity, exoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with pneumatic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,096.48 / $1,258.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,318.26 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $954.99 / $1,348.96
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,949.84 / $2,398.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,202.26 / $1,445.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,479.11 / $4,168.69