go back

Vermont rates for HCPCS L5697

Addition To Lower Extremity Above Knee Or Knee Disarticulation Pelvic Band

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.69 / $62.69 / $72.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.21 / $60.21 / $94.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $60.21 / $64.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$60.21 / $60.21 / $94.42
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$43.95 / $60.21 / $64.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.73 / $76.09 / $148.52