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Maine rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,434.55 / $1,916.84 / $1,916.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,531.31 / $3,279.55 / $6,079.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,481.65 / $1,547.65 / $2,136.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,769.38 / $1,769.38 / $2,091.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,291.65 / $1,769.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,304.35 / $2,304.35 / $2,304.35
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,602.54 / $1,916.84 / $1,916.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.59 / $1,823.00 / $3,265.30