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Maine rates for HCPCS L5000

Partial Foot Shoe Insert With Longitudinal Arch Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.22 / $408.43 / $408.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.36 / $698.79 / $1,295.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.58 / $386.99 / $455.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$425.14 / $459.90 / $459.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $459.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.01 / $491.01 / $491.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.46 / $408.43 / $408.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.70 / $398.95 / $695.75