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Vermont rates for HCPCS L5658

Addition to lower extremity, socket insert, above knee (AK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $347 · 10th–90th $166–$3720%20%40%10th90th$347Professionalmedian $245 · 10th–90th $186–$3160%20%10th90th$245$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $245.47 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $501.19
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $223.87 / $346.74
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $331.13 / $1,023.29