go back

Vermont rates for HCPCS L5639

Addition to lower extremity, below knee (BK), wood socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $812.83 / $1,071.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $870.96 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $891.25
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,659.59 / $1,778.28
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $891.25 / $1,513.56
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $1,348.96 / $3,715.35