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Maine rates for HCPCS L5160

Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,754.23 / $7,762.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $6,025.60 / $6,918.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $5,128.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $3,630.78 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $3,630.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $4,466.84 / $5,248.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,019.95 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $3,019.95 / $3,311.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $3,467.37 / $4,897.79