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Maine rates for HCPCS L5540

Preparatory, below knee (BK) PTB type socket, nonalignable system, pylon, no cover, SACH foot, laminated socket, molded to model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,082.63 / $1,668.82 / $1,668.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,203.77 / $2,855.19 / $5,292.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.91 / $1,386.29 / $1,860.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,599.98 / $1,599.98 / $1,821.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,167.99 / $1,167.99 / $1,599.98
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,006.19 / $2,006.19 / $2,006.19
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,395.17 / $1,668.82 / $1,668.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$835.04 / $1,236.16 / $2,842.78