go back

Vermont rates for HCPCS L5665

Addition to lower extremity, socket insert, multidurometer, below knee (BK)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $371.54 / $457.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $331.13 / $478.63
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $645.65 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $616.60 / $1,698.24