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Vermont rates for HCPCS L6925

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal electrodes, cables, two batteries and one charger, myoelectronic control of terminal device

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,193.60 / $5,193.60 / $5,992.63
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,261.93 / $7,261.93 / $7,822.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $5,759.27
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,261.93 / $7,261.93 / $7,822.39
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,301.21 / $5,301.21 / $5,759.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,613.50 / $8,479.94 / $8,849.33