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Maine rates for HCPCS L5420

Immediate postsurgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change above knee (AK) or knee disarticulation

Facilitymedian $1,905 · 10th–90th $1,259–$2,2910%20%10th90th$1,905Professionalmedian $1,148 · 10th–90th $794–$1,8620%10%20%10th90th$1,148$1.0K$2.0K$5.0K$10.0K

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
$794.33 / $1,071.52 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,137.96 / $2,454.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,148.15 / $1,584.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,905.46
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $1,258.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,202.26 / $1,258.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $1,584.89 / $1,862.09