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Maine rates for HCPCS L2387

Addition To Lower Extremity Polycentric Knee Joint For Custom Fabricated Knee Ankle Foot Orthosis Each Joint

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.62 / $150.88 / $150.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$221.10 / $286.45 / $530.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.76 / $118.98 / $118.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$116.51 / $116.51 / $116.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.05 / $85.05 / $116.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.28 / $201.28 / $201.28
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.97 / $150.88 / $150.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$59.25 / $92.18 / $92.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.68 / $124.02 / $285.22