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Maine rates for HCPCS L1690

Combination Bilateral Lumbo-Sacral Hip Femur Orthosis Providing Adduction And Internal Rotation Control Prefabricated Includes Fitting And Adjustment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.59 / $1,380.31 / $1,380.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,022.55 / $2,620.40 / $4,857.39
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,250.07 / $1,328.20 / $1,328.20
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,300.55 / $1,300.55 / $1,671.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$949.40 / $949.40 / $1,300.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,841.20 / $1,841.20 / $1,841.20
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.44 / $1,380.31 / $1,380.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.33 / $1,134.50 / $2,608.98