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Vermont rates for HCPCS L5643

Addition To Lower Extremity Hip Disarticulation Flexible Inner Socket External Frame

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,215.49 / $1,215.49 / $1,402.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,830.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,167.30 / $1,244.40
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,167.30 / $1,167.30 / $1,830.72
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$852.13 / $1,167.30 / $1,244.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.56 / $1,475.47 / $2,879.50