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Maine rates for HCPCS L5617

Addition to lower extremity, quick change self-aligning unit, above knee (AK) or below knee (BK), each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.58 / $466.42 / $466.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$615.95 / $798.01 / $1,479.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.51 / $387.51 / $519.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.96 / $436.96 / $508.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.98 / $318.98 / $436.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.72 / $560.72 / $560.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.93 / $466.42 / $466.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.33 / $399.46 / $794.53