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Maine rates for HCPCS L2755

Addition to lower extremity orthosis, high strength, lightweight material, all hybrid lamination/prepreg composite, per segment, for custom fabricated orthosis only

Facilitymedian $162 · 10th–90th $89–$1950%20%40%10th90th$162Professionalmedian $89 · 10th–90th $68–$1350%10%20%10th90th$89$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $87.10 / $138.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $181.97 / $208.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $85.11 / $112.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $112.20
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $64.57 / $89.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $162.18
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $89.13 / $95.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$44.67 / $69.18 / $77.62
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $134.90