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Maine rates for HCPCS L5020

Partial Foot Molded Socket Tibial Tubercle Height With Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.67 / $1,684.29 / $1,684.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.21 / $2,881.67 / $5,341.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.87 / $1,517.87 / $1,877.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,486.28 / $1,486.28 / $1,838.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.98 / $1,084.98 / $1,486.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,024.79 / $2,024.79 / $2,024.79
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,408.12 / $1,684.29 / $1,684.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.89 / $1,428.89 / $1,428.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$914.30 / $1,247.61 / $2,869.14