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Connecticut rates for HCPCS L5781

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,291.38 / $2,291.38 / $2,291.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,051.64 / $2,126.06 / $2,296.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,653.72 / $4,714.47 / $5,393.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,753.59 / $2,902.12 / $2,902.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,886.72 / $2,886.72 / $2,886.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,107.31 / $2,107.31 / $2,886.72
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,064.41 / $3,064.41 / $3,064.41
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,064.41 / $3,064.41 / $4,337.32
Health New England
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,441.78 / $3,441.78 / $3,441.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,794.92 / $2,352.00 / $3,243.48