go back

Vermont rates for HCPCS L5855

Addition Endoskeletal System Hip Disarticulation Mechanical Hip Extension Assist

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$180.88 / $180.88 / $208.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $272.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $246.97
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.78 / $239.78 / $272.44
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.04 / $239.78 / $246.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.02 / $247.02 / $247.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.28 / $219.57 / $428.51