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Vermont rates for HCPCS L5972

All Lower Extremity Prostheses Foot Flexible Keel (Revised 01012013)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.63 / $240.63 / $277.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.93 / $398.93 / $398.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.77 / $293.77 / $362.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.45 / $293.77 / $313.17
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.77 / $293.77 / $362.42
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.45 / $293.77 / $313.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.00 / $317.95 / $570.04