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Vermont rates for HCPCS L5694

Addition to lower extremity, above knee (AK), pelvic control belt, padded and lined

Facilitymedian $145 · 10th–90th $141–$2140%50%10th90th$145Professionalmedian $141 · 10th–90th $93–$1620%20%10th90th$141$100.0$200.0$500.0$1.0K

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
$93.33 / $141.25 / $162.18
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $213.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $141.25
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $281.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $144.54 / $173.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $177.83 / $588.84