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Maine rates for HCPCS L5210

Above Knee Short Prosthesis No Knee Joint (Stubbies) With Foot Blocks No Ankle Joints Each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,383.32 / $2,132.33 / $2,132.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,815.88 / $3,648.23 / $6,762.66
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,760.19 / $1,858.58 / $2,376.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.89 / $1,819.89 / $2,327.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.52 / $1,328.52 / $1,819.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,563.40 / $2,563.40 / $2,563.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,782.68 / $2,132.33 / $2,132.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,776.27 / $1,776.27 / $1,776.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,053.00 / $1,579.50 / $3,632.35