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Maine rates for HCPCS L5400

Immediate Post Surgical Or Early Fitting Application Of Initial Rigid Dressing Including Fitting Alignment Suspension And One Cast Change Below Knee

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.38 / $972.89 / $972.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,284.77 / $1,664.54 / $3,085.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$878.44 / $921.82 / $1,084.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$902.63 / $902.63 / $1,061.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$658.92 / $658.92 / $902.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,169.58 / $1,169.58 / $1,169.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$813.37 / $972.89 / $972.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.27 / $1,169.58 / $1,600.16