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Maine rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Facilitymedian $5,012 · 10th–90th $2,884–$6,0260%20%10th90th$5,012Professionalmedian $2,884 · 10th–90th $2,089–$4,8980%10%10th90th$2,884$2.0K$5.0K$10.0K$20.0K

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
$2,041.74 / $2,818.38 / $7,413.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $5,623.41 / $6,456.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $5,011.87
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,884.03 / $3,311.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $3,019.95 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $4,168.69 / $4,786.30