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Vermont rates for HCPCS L7400

Addition To Upper Extremity Prosthesis Below Elbow Elbow/Wrist Disarticulation Ultralight Material (Titanium Carbon Fiber Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.23 / $176.23 / $203.34
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.35 / $239.35 / $239.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.73 / $174.73 / $174.73
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$239.35 / $239.35 / $239.35
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.73 / $174.73 / $174.73
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.11 / $248.45 / $417.48