go back

Vermont rates for HCPCS L5694

Addition To Lower Extremity Above Knee Pelvic Control Belt Padded And Lined

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.66 / $141.66 / $163.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.85 / $140.85 / $213.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.82 / $102.82 / $135.49
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$140.85 / $140.85 / $213.38
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.82 / $102.82 / $135.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.63 / $231.32 / $241.40