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Vermont rates for HCPCS L5683

Addition To Lower Extremity Below Knee/Above Knee Custom Fabricated Socket Insert For Other Than Congenital Or Atypical Traumatic Amputee Siliconegel Elastomeric Or Equal For Use With Or Without Locking Mechanism Initial Only(For Other Than I Nitial Use Code L5673 Or L5679)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.33 / $756.33 / $872.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.52 / $950.52 / $1,139.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.88 / $883.57 / $1,013.30
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.52 / $950.52 / $1,139.15
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$693.88 / $950.52 / $1,013.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.89 / $1,164.74 / $1,288.70