go back

Vermont rates for HCPCS L5696

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.87 / $138.87 / $160.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.76 / $138.76 / $209.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $138.76 / $147.91
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.76 / $138.76 / $209.17
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.29 / $138.76 / $147.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.65 / $168.58 / $328.98