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Vermont rates for HCPCS L5652

Addition to lower extremity, suction suspension, above knee (AK) or knee disarticulation socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $316.23 / $363.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.47 / $245.47 / $363.08
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $512.86 / $691.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $346.74 / $416.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $489.78 / $1,348.96