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Vermont rates for HCPCS L5642

Addition to lower extremity, above knee (AK), leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.88 / $362.88 / $418.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.41 / $530.41 / $546.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $463.16
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$530.41 / $530.41 / $546.55
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.20 / $387.20 / $463.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.22 / $549.04 / $859.67