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Vermont rates for HCPCS L5961

Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,090.30 / $3,715.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $3,715.35
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,265.80 / $5,128.61 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $4,073.80 / $11,481.54