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Vermont rates for HCPCS L5707

Custom Shaped Protective Cover Hip Disarticulation

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$836.02 / $836.02 / $964.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,259.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $930.57 / $1,313.59
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,232.20 / $1,232.20 / $1,259.18
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$899.51 / $1,232.20 / $1,313.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.79 / $1,287.48 / $1,980.54