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Vermont rates for HCPCS L6935

Below elbow, 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
$5,070.70 / $5,070.70 / $5,850.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,503.37 / $7,503.37 / $7,637.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,477.46 / $5,867.38 / $7,998.97
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,503.37 / $7,503.37 / $7,637.26
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,477.46 / $7,503.37 / $7,998.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,455.96 / $6,155.28 / $12,012.48