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Maine rates for HCPCS L5595

Preparatory, hip disarticulation/hemipelvectomy, pylon, no cover, SACH foot, thermoplastic or equal, molded to patient model

Facilitymedian $6,166 · 10th–90th $3,548–$7,5860%20%10th90th$6,166Professionalmedian $3,162 · 10th–90th $2,291–$6,0260%10%10th90th$3,162$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
$2,290.87 / $2,754.23 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $7,079.46 / $8,128.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $6,025.60
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,630.27 / $2,630.27 / $3,548.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $5,248.07 / $6,165.95
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,884.03 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $3,162.28 / $4,365.16
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $4,897.79 / $5,248.07