go back

Vermont rates for HCPCS L6696

Addition To Upper Extremity Prosthesis Below Elbow/Above Elbow Custom

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.33 / $756.33 / $872.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.63 / $886.63 / $886.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.24 / $647.24 / $945.19
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$886.63 / $886.63 / $886.63
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$647.24 / $886.63 / $945.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$515.48 / $1,066.57 / $1,791.73