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Vermont rates for HCPCS L5822

Addition Endoskeletal Knee-Shin System Single Axis Pneumatic Swing Friction Stance Phase Control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.87 / $1,329.87 / $1,534.46
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,204.80 / $2,204.80 / $2,204.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.82 / $1,367.82 / $2,002.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.51 / $1,272.74 / $1,458.16
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.82 / $1,367.82 / $2,002.99
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.51 / $1,367.82 / $1,458.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.44 / $1,347.44 / $1,347.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.38 / $1,614.31 / $3,150.46