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Vermont rates for HCPCS L5654

Addition To Lower Extremity Socket Insert Symes (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.99 / $258.99 / $298.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.16 / $306.16 / $390.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.50 / $306.16 / $326.39
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$306.16 / $306.16 / $390.08
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.50 / $306.16 / $326.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.52 / $314.39 / $613.54